Free For You - Prescription Change Log

>> Be sure to print / make multiple copies of this form once you download it.

Because of all the changes I filled two and started a third in the first couple months<<

When I was discharged after my transplant, I was given a single sheet with six medications — three temporary, three permanent — and told to erase and rewrite each time a dose changed.

During the first three months, the changes were almost weekly.

Anyone who has erased the same spot four or five times knows what happens: the paper doesn’t survive.

Worse, I sometimes received calls telling me to change a dose, and I’d reply, “That’s already my current dose.”

Then came the questions:

• “When was that change?”
• “Who told you to make that change?”

I needed something better.

So I created a simple, organized Prescription Change Log with:

• Date
• Doctor/RN
• Medication
• Change
• Notes

When the Lead Nephrologist at my transplant center saw it, she told me it was one of the most useful and organized ways she’d seen a patient track medication changes.

I offered it to the center to include in future patient packets — I don’t know if they used it, but I know it helped me.

Now I’m offering it here, free, for transplant patients everywhere.

I hope it helps you stay organized, confident, and prepared during a time when clarity matters most.

— John