Drug Codes/ October 20, 1995 - SAMHSA
Please list all medications you are currently taking, including prescription drugs, over-the-counter drugs, vitamins, herbal remedies and supplements. (Two examples are listed below.) Name of medication Dosage in mg. Number of times taken When (daily, as needed) i.e. Aleve 275 2x daily. i.e. Viagra … ................
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