Medications
Please list all medications (Prescription/Over-the-Counter/Vitamins/Herbs) below. ALL medications must be in the ORIGINAL CONTAINER and will be left with and dispensed by the Health Supervisor. Prescribed medicines must be kept in the original packaging/bottle that identifies the prescribing physician (if prescription), name of medicine, dosage & frequency.
We understand that medications may change and this form may be updated at check-in if necessary.