This "Personal Health Record", provided by Allen Hospital, can be folded and kept conveniently in your wallet or purse.

Always carry this record with you and keep it current. Take it with you every time you see your doctor or pharmacist.

Remember to ask your doctor or pharmacist:

• What is the name of the drug and what is it supposed to do?
• How and when do I take it – and for how long?
• What foods, drinks, other medicines or activities should I avoid while taking this drug?
• Are there any side effects? What do I do if they occur?
• Is there written information available about the drug?