The following form is provided by GPhA's Public Affairs Committee. You can customize this form with your pharmacy name and logo and provide it to patients for a medication record.
Medication Reconciliation Form
Georgia Pharmacy Association 50 Lenox Pointe, NE * Atlanta, Georgia 30324 * 404-231-5074 * fax 404-237-8435 Toll free 888-871-5590 Email Webmaster
A Tradition of Excellence Since 1875 Copyright 2009 Georgia Pharmacy Association All rights reserved.
