MEDICATION CARD for your wallet FortHealthCare.com (920) 568-5000 611 Sherman Ave. East Fort Atkinson, WI 53538 Show this to every doctor at each visit • List all medicines you are taking. • Never take any medicine prescribed for someone else. • Present this card when you are seen in the emergency room. • Cross off medicine you no longer take. • Keep this card with you at all times Vaccination Record Name: Primary Care Provider: Phone: Pharmacy: Phone: Allergies: Optional: I have an advanced directive filed at Mo./Yr Mo./Yr Mo./Yr Mo./Yr Vaccinations Tetanus Pneumococcal Influenza Other FortHealthCare.com/SafeMeds • (920) 568-5000 611 Sherman Ave. East Fort Atkinson, WI 53538 Community members desiring additional brochures should email requests to: [email protected] DRUG DROP-OFF SITES Jefferson County Sheriff’s Office – Jail Lobby 411 S. Center Avenue, Jefferson, WI 53549 Open every day 24 hours a day Watertown Police Department 106 Jones Street, Watertown, WI 53094 Open every day 24 hours a day Lake Mills Police Department 200A Water Street, Lake Mills, WI 53551 Open Monday - Friday from 7 am to 5 pm Fort Atkinson Police Department 101 S. Water Street West, Fort Atkinson, WI 53538 Open every day 24 hours a day Whitewater Police Department 312 W. Whitewater Street, Whitewater, WI 53190 Open every day 24 hours a day jeffersoncountywi.gov/cleansweep Accepted Drugs: unused prescriptions, over the counter drugs, inhalers, vitamins, and veterinary/pet medicines. NO Sharps/needles, radioactive materials, oxygen tanks or medical equipment Check with your local health department, pharmacy or clinic/hospital for sharps disposal. SAFE MEDICATION MANAGEMENT #PE23-JAN16
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MED
ICAT
ION
CARD
for
your
wal
let
FortH
ealth
Care
.com
(920
) 568
-500
0
611
Sher
man
Ave
. Eas
t Fo
rt At
kins
on, W
I 535
38
Show
this
to e
very
do
ctor
at e
ach
visi
t•
List a
ll m
edic
ines
you
ar
e ta
king
.•
Nev
er ta
ke a
ny
med
icin
e pr
escr
ibed
for
som
eone
else
.•
Pres
ent t
his
card
whe
n yo
u ar
e se
en in
the
em
erge
ncy
room
.•
Cro
ss o
ff m
edic
ine
you
no
long
er ta
ke.
• Ke
ep th
is ca
rd w
ith y
ou a
t al
l tim
es
Vacc
inat
ion
Reco
rd
Nam
e:
Prim
ary
Car
e
Prov
ider
:
Phon
e:
Phar
mac
y:
Phon
e:
Alle
rgie
s:
Opt
iona
l:
I hav
e an
adv
ance
d di
rect
ive
filed
at
Mo.
/Yr
Mo.
/Yr
Mo.
/Yr
Mo.
/Yr
Vacc
inat
ions
Teta
nus
Pneu
moc
occa
l
Influ
enza
Oth
er
FortHealthCare.com/SafeMeds • (920) 568-5000611 Sherman Ave. East
Fort Atkinson, WI 53538
Community members desiring additional brochures shouldemail requests to: [email protected]
DRUG DROP-OFF SITESJefferson County Sheriff’s Office – Jail Lobby 411 S. Center Avenue, Jefferson, WI 53549
Open every day 24 hours a day
Watertown Police Department106 Jones Street, Watertown, WI 53094
Open every day 24 hours a day
Lake Mills Police Department200A Water Street, Lake Mills, WI 53551Open Monday - Friday from 7 am to 5 pm
Fort Atkinson Police Department101 S. Water Street West, Fort Atkinson, WI 53538
Open every day 24 hours a day
Whitewater Police Department312 W. Whitewater Street, Whitewater, WI 53190
Open every day 24 hours a day
jeffersoncountywi.gov/cleansweepAccepted Drugs: unused prescriptions, over the counter drugs, inhalers, vitamins, and veterinary/pet medicines.
NO Sharps/needles, radioactive materials,oxygen tanks or medical equipment
Check with your local health department,pharmacy or clinic/hospital for sharps disposal.
SAFE MEDICATIONMANAGEMENT
#PE23-JAN16
Share with your healthcare provider a current list of each medicine you take. Healthcare providers are physicians, nurses and pharmacists. They can help protect you against dangerous drug interactions and reactions.
Your list should include:• Full name of each prescription, over-thecounter
medication, vitamin or herbal supplement you take
• Amount you take
• Times of day you take each medication
• Ordering physician’s name
• Reason for taking a medication
• Start date for taking each
• Pharmacy’s phone number where you buy each medication
• Medications and foods you can’t take because of allergy or intolerance, describing your reaction
SAFE MEDICATIONMANAGEMENT
MEDICATIO
NDO
SE (IF KNO
WN
)TIM
ES TAKEN
PURPO
SE FOR U
SEW
HO
TOLD M
E TO TA
KE ITDATE STO
PPEDDATE STA
RTED
Safety Tips For Taking Medications:• Tell your healthcare provider about all
medications you take
• Use a chart or a pill organizer
• Update your list when you start a new medication
• Understand your doctor or pharmacist’s instructions and ask questions
• Ask your pharmacist for information about each new medication
• Know what activities, foods, drinks or other medications to avoid
• Ask your healthcare provider about side effects
• Know how and when to get refills
• Plan ahead for refills, especially before you will be away from home
• Learn how to store medications
• Do not take over-the-counter medications or herbal remedies without asking your healthcare provider
• Never take someone else’s prescription medicine or offer your prescription medicine to someone else
• Always finish all of a medicine unless your doctor tells you differently
• To save money, ask if a generic brand is available
• Keep a list of your past medical and surgical history
• Safely dispose of unwanted medications at an area Clean Sweep event or drop off site (see back panel)
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