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Serving Sizes

My
Medication List
Use this chart to keep track of all your medications. Any time your health care provider prescribes a medication, tells you to
stop one or changes a dosage, record the change here. Share this list with any new health care provider you visit. Keep a copy
in your wallet or purse.
Managing
a ag Strength
Brand Name
g Quantity How Often
Generic Name Purpose Notes/Date
(if any) (dose) per Dose to Take

AFib
A Program for Patients & Caregivers

© 2016 American College of Cardiology. All rights reserved.


List all over-the-counter medications, vitamins, minerals, herbs and supplements you take:

CardioSmart.org

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