Medication List
Purpose of this medication list form:
In Oregon, long-term services and support agencies, including those providing employment supports for individuals with disabilities, are required to maintain up-to-date medication lists for their clients (OAR 411-004). These lists are essential to ensure that staff are aware of any medications participants are taking, particularly those that may impact their ability to work or interact with others. In the event of an emergency, this information may be shared with first responders. Having access to this list helps first responders make informed decisions to avoid potential conflicts and ensure the individual's safety.
Reminder
*We do NOT administer medications to Participants (Clients).
Name of Participant (Client)
*
First Name
Last Name
The individual named above:
*
Is currently taking medication.
Is NOT currently taking medication.
Current Medications: Please list all medications the individual is taking, including the name, dosage, and how often they are taken."
Submitted By:
*
Full Name
Relationship (or type Self)
Submit
Should be Empty: