Use This Universal Medication Form to Receive Better Treatment

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St. Mary’s Hospital is pleased to announce an initiative for all patients to use one form for medications.  This free Universal Medication Form can be folded and stored in a wallet for easy access.  Patients can fill out their immunization records and list all medications, including prescription, over-the-counter and herbals.  This simple and easy-to-use form is good for emergencies and for any time patients need to quickly recall immunizations and prescriptions.

The fo
rm is available through Health Connections and for download online on the hospital Web site.  Log on to, click on the Patients tab at the top of the screen, then click on the Universal Medication Form on the left-hand side.  Or, download the form directly at


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