You can keep track of your medications—and help your doctors provide the proper care—with a free medication form available from Bridgeport Hospital.

The seven-and-a-half-inch by 11-inch form folds conveniently into your wallet. In addition to a place to list prescription, over-the-counter and herbal medicines being taken, the form also has space to record allergies and immunizations.

"The medication form can be especially helpful in an emergency situation, when time is of the essence," says Michael Werdmann, MD, Chairman of Bridgeport Hospital's Emergency Department. "Although a patient's personal physician will be contacted in an emergency and the patient's medical record checked, the hospital record may not reflect changes that have occurred since a patient's last hospitalization."

In addition, Dr. Werdmann says that having the medication form can help healthcare providers assess whether any symptoms are medication-related and avoid using medications that might duplicate or interact with those already being taken by the patient.

Bridgeport Hospital recommends that people record any changes in medications or dosages to keep the information on the form current. People are also asked to list the reasons for taking the medications listed.

Click Here to download your Medication Record.

For a free holder to protect the medication form in your wallet,
please call toll free 1.888.357.2396.