Medication Reconciliation Form

Undisclosed herbal and traditional medicine use is one of the biggest blind spots in patient safety — most patients won't mention it unless directly asked. This 2-page Word template closes that gap. Built on WHO High 5s Medication Reconciliation guidance, it captures prescribed meds, OTC products, AND a dedicated herbal/traditional medicine table screening for hepatotoxicity, interactions, and safety concerns. Covers admission, transfer, and discharge points with full discrepancy tracking and clinician sign-off. Designed by a practicing pharmacist for real clinical use — usable in any country, any facility. Editable .docx, instant download.