Your Medicine: Be Smart. Be Safe. (with wallet card)

List of Doctors and Pharmacists

List Your Doctors and Pharmacists Here

Keep this guide with your medicines in case you have any questions, concerns, or worries.

Doctor: _______________________________________________________________

Contact Information: ________________________________________________________________

Doctor: _______________________________________________________________

Contact Information: ________________________________________________________________

Doctor: _______________________________________________________________

Contact Information: ________________________________________________________________

Doctor: _______________________________________________________________

Contact Information: ________________________________________________________________

Doctor: _______________________________________________________________

Contact Information: ________________________________________________________________

Nurse: ________________________________________________________________

Contact Information: ________________________________________________________________

Pharmacist: ____________________________________________________________

Phone number: _______________________________________________________________

24-hour Pharmacy: _______________________________________________________

Phone number: ________________________________________________________________


Return to Document

Page last reviewed July 2015
Internet Citation: List of Doctors and Pharmacists. July 2015. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/patients-consumers/diagnosis-treatment/treatments/safemeds/yourmedsdocs.html