Are you getting the most from your medications?
What benefits are there from having a Medication Review?
Am I a good candidate for a Medication Review?
Are you taking several medications or worry that you take too many (including natural products and non-prescription products)?
Do any of your medications make you feel unwell?
Are your prescriptions unaffordable or have you not taken a prescribed medication because it is too expensive?
Do you have trouble understanding or remembering how to take yourmedicine?
Do you ever have trouble using your medicines (swallowing, puffers, eye drops, patches)?
Do you worry that your medicines are working against each other?
Have you recently been discharged from the hospital?
Do you wish you knew more about your medicine?
* If any of any of these apply to you, schedule a visit with our pharmacist to review all your medications. This visit may take up to 60 minutes.
Please remember to bring all medications (including over the counter, herbal, vitamins, etc.) to your appointment along with the back of this form filled out. If you turn in this form before your appointment, it will help the pharmacist look into any concerns you may have before your appointment.
Appointment Date & Time: