Medication handoff checklist
— → — · —
Made with the free tool at
dosebeacon · rork.live
- Current medication list is attached and dated
- List was checked against the actual labels, not memory
- Schedule for each medicine is written down
- Allergies and past reactions are written down
- Where the medicines are kept is explained
- What's already been given or reported today is clear
- Any dose nobody is sure about is flagged, not guessed
- Pharmacy name and phone are included
- Emergency contacts and local emergency number are included
| Task | Responsible |
|---|---|
| Morning medicines | ________________ |
| Evening medicines | ________________ |
| Refill pick-ups | ________________ |
| Weekly pill organizer fill | ________________ |
Pharmacy
—
Refills pending
—
Unresolved records / unsure doses
—
Questions for clinicians
—
Emergency contacts
—
Copied from prescription labels and the people involved. Not medical advice. Keep it up to date and review it with a pharmacist or prescriber. Ask them before changing how any medicine is taken.