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The Med Form helps you and your family members track medications you are taking from prescription to over-the-counter herbals and vitamins. This document is designed to provide physicians and others with a current list of all of your medicines. By sharing The Med Form with their providers, patients become active participants in the healthcare team.

Here are some easy instructions about The Med Form:

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    		 Keep The Med Form with you at all times, in case of a medical emergency.
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    		 Take The Med Form with you to all doctor and other healthcare provider visits (e.g., nurse practitioner or dietitian).
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    		 Write down all of the medicines you are taking, including over-the-counter medications such as vitamins, herbals and others.
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    		 Include the name of the doctor who prescribed the medication. You may also write why you are taking the medicine (e.g., high blood pressure, high blood sugar, high cholesterol). If you are not sure why you are taking the medication please write don't know.
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    		 When you are discharged from the hospital, someone will speak with you about which medicines to take and which medicines to stop taking. Because patient medications often are changed during hospitalization, it's important that you complete a new Med Form. Take the new form to all doctor visits following your hospitalization to discuss it with him or her.
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    		 Remember to update your Med Form when your doctor changes, stops or updates your medication.
    Why The Med Form?

    The Med Form will:

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    		 help you and your family members remember all of the medications you are taking;
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    		 provide your doctor(s) and other healthcare providers a current list of all medicines, including over-the-counter medicines, vitamins and herbals; and
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    		 detect concerns about medicines by including a comprehensive listing of medications for your healthcare team.

    We've provided two versions of The Med Form, including:

    The Med Form     (full page size)

    The Med Form (wallet size)

    Instructions:
    Type in the information online and print it out or print the Med Form and complete it using a pen. Once you have completed and printed out the form, keep it with you at all times.

    If you do not have a printer, public libraries allow library-card holders to access to Internet services and printers. Fees vary so check with your local library.

    Valley ENT gratefully thanks these various organizations for the ability to include this information and form on this corporate web page. This forms represents the consolidated effort of these organizations and many other healthcare providers with an express goal of providing better health care in the State of Arizona.