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MY PERSONAL = ;
MEDICATION =
RECORD
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Content-Type: text/html; charset="us-ascii" Slide 1
INSERT <= span style=3D'position:absolute;top:18.92%;left:47.19%;width:41.91%;height:5.08= %'>INSURANCE CARD HERE
INST= RUCTIONS FOR USE:
•<= /span>Use this booklet to keep track of your prescription drugs, over-the-counter (OTC) drugs, herbal supplements, and vitamins. 
•<= /span>Share the information with your doctors and pharmacists at all visits.
•Keep it in your wallet= or purse.
•Always use a pencil
Medicare=
Smith= 3;
9384
Medicare=
John= Q. Smith
INSURANCE CARD
Explan= ation of why using this record is beneficial and what sort of data is to be recorded
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Your Name:
Date of Birth:
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Emergency Contact Name & Relationship:
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PRIMARY CARE PHYSICIAN 
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PERSONAL INFORMATION
You should review this record when…
§  Starting or stopping a new medicine
§  Changing a dose
§  Visiting your doctor or pharmacis= t
Last Updated  __________________
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= OTHER PRESCRIBING PHYSICIANS
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•Phone#:
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•Specialty:
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