Medication safety

Safe medication use starts with you. In an emergency, a med list could save your life or the life of your loved one.

Health care providers need a complete medication list that includes your:

• Prescribed and over-the-counter medications.
• Inhalers.
• Patches.
• Ointments.
• Eye drops.
• Herbs.
• Vitamins.
• Nicotine gum.

Make a list that includes all the items above that you take or use, then share it with your health care team. It will allow them to make better-informed decisions about your treatment.

Medication list forms

To make a medication list, simply print off the form below (in the language of your choice) and update it frequently. Then, bring it with you to all your health care appointments.

This document is not saved by Columbus Community Hospital and is not part of your official medical record unless you share it with your health care provider. 

• English
• Spanish
• Somali

Medication list forms such as this one are also available at most local clinics and pharmacies. 

Contact us 

For more information, contact Columbus Community Hospital’s patient education coordinator at 402-562-4624.

Columbus Community Hospital
4600 38th St.
Columbus, Nebraska 68602-1800
402-562-4624