Your Medicine: Be Smart. Be Safe. List of Doctors and Pharmacists (DOC)

You can learn more about how to take medicines safely by reading this guide. It answers common questions about getting and taking medicines and has handy forms that will help you keep track of information.

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

Current as of April 2011
Internet Citation: Your Medicine: Be Smart. Be Safe. List of Doctors and Pharmacists (DOC). April 2011. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/patients-consumers/diagnosis-treatment/treatments/safemeds/yourmedsdocs.html