Medicine and Supplement List Worksheet to Bring to Appointments
A plain table to copy or print that lists medicines, herbs and supplements, health conditions and upcoming procedures, so a pharmacist or clinician can check them together.
Content last updated . This page has not been medically reviewed.
Safety first. Supplements can cause side effects and interact with medicines. Read mushroom safety and interactions before you use any mushroom product.
Why bring a list. NCCIH advises telling all your health care providers about every dietary supplement and medication you take, so they can help you avoid harmful interactions. [1] FDA says to bring a list of all supplements and medications at every visit, including dosages and how many times a day you take them. [2] This page is a blank table you can copy into a notes app or print. Nothing you write on paper or in your own document is sent to this site.
Privacy note. The list holds health information. Keep the printed copy somewhere private, avoid posting a photo of it publicly, and share it only with the people caring for you.
How to fill it in
- Copy the name, plant (if shown) and amount from the label, not from memory. The amounts here are only what the label or prescriber says. This page gives no amounts.
- Include everything: prescription medicines, over-the-counter medicines, vitamins, minerals, herbal products, teas or extracts you use for health, and creams or drops. FDA asks people to discuss prescription and over-the-counter drugs, supplements, vitamins, botanicals, minerals and herbals, as well as foods. [3]
- NCCIH suggests you could also bring the bottles. [1] FDA notes some people find it easiest to put all their products in a bag for the visit. [2]
- Update the list before each visit. [1]
Table 1: Prescription and over-the-counter medicines
| Name on label | What it is for | Amount and how often (as on label or prescriber) | Started | Prescriber or pharmacy |
|---|---|---|---|---|
Table 2: Herbs, supplements, teas and extracts
| Product type (capsule, tea, tincture, gummy, cream) | Plant name and part, if on the label | Amount and how often (as on label) | Why I use it | Started | Any new symptoms since starting |
|---|---|---|---|---|---|
The plant name matters, because common names can refer to different plants. See botanical names and plant parts on labels and the common-to-scientific names table.
Table 3: About you
| Question | My answer |
|---|---|
| Health conditions (including liver, kidney, heart, blood pressure, diabetes) | |
| Allergies and past reactions | |
| Pregnant, trying to become pregnant, or breastfeeding? | |
| Surgery, dental work or a procedure planned? Date | |
| Cancer or HIV treatment? | |
| Questions I want to ask |
Why these rows. NCCIH says supplements may interact with medicines or pose risks if you have certain medical problems or are going to have surgery. [4] For surgery, tell your providers as far in advance as possible. [5] FDA asks you to tell the professional if your health status has changed, particularly if you are pregnant, breastfeeding or have had a recent illness or surgery. [2] NCCIH raises growing concern that supplements may interfere with cancer and HIV treatments. [1]
Next steps
Take the list to a pharmacist or clinician along with the question checklist. A longer printable version for all supplements is at a printable medicine and supplement list, and procedure-specific advice is at how to prepare your supplement list for a procedure. Do not stop or change a prescribed medicine because of anything you notice on the list; ask the prescriber or pharmacist.Frequently asked questions
Do I list teas and foods as well as pills?
Include anything you use for health, including herbal teas and extracts. FDA advises discussing botanicals and herbals, and the foods you eat, with your doctor or pharmacist. [3]
Should I write the amount I take?
Yes, copy it from the label or the prescriber's instructions. NCCIH and FDA both ask for the doses and how often you take each product. [1][2] This site does not recommend amounts.
How often should I update it?
NCCIH says to update the information each time you visit a provider's office. [1]
Is it safe to keep this list on my phone?
The sources we read do not address phone storage. Treat it as private health information and protect your device as you would other personal records.
What if I forget a product?
Tell the pharmacist or clinician as soon as you remember. NCCIH says it is important to tell providers about all supplements and medications. [1]
References
- NCCIH (US), Know the Science, How Medications and Supplements Can Interact: Talk With Your Health Care Providers. Read 2026-10-23.
- FDA (US), Mixing Medications and Dietary Supplements Can Endanger Your Health (Consumer Update, 2022). Read 2026-10-23.
- FDA (US), Drug Interactions: What You Should Know. Read 2026-10-23.
- NCCIH (US), Using Dietary Supplements Wisely. Read 2026-10-23.
- NCCIH (US), Know the Science, How Medications and Supplements Can Interact: Some Medication-Supplement Interactions Can Be Serious. Read 2026-10-23.