Please list below all the allopathic medications and supplements you are
taking, as well as the name of the doctor who prescribed them.
Medication________________________________ Dose______________________
Prescribed by______________________________Taken since_________________
Prescribed for________________________________________________________
Side effects__________________________________________________________
Medication________________________________ Dose______________________
Prescribed by______________________________Taken since_________________
Prescribed for________________________________________________________
Side effects__________________________________________________________
Medication________________________________ Dose______________________
Prescribed by______________________________Taken since_________________
Prescribed for________________________________________________________
Side effects__________________________________________________________
Medication________________________________ Dose______________________
Prescribed by______________________________Taken since_________________
Prescribed for________________________________________________________
Side effects__________________________________________________________
Medication________________________________ Dose______________________
Prescribed by______________________________Taken since_________________
Prescribed for________________________________________________________
Side effects__________________________________________________________
