HAIL Medication List

Print this webpage to use the list, or use it as you make your own.

Name of Consumer ___________________________________

Name of ILS ________________________________________

Date of Visit _________________________________________

HAIL Medication List
Time of Day	Name of Drug	Dose	How I take it? (how much, how often, with or without food, etc.)	Health Condition (Why I take it?)	Who told me to take it?
Morning

Afternoon

Evening

Night


Medicines I use on an as needed basis

Notes: