Most medication mix-ups are paper problems: the schedule lives in one person's head, the refill dates live on receipts, and the pharmacy number lives in somebody's phone. This free printable puts all three on one sheet. You fill in the med names yourself from the pharmacy label, then tick circles through the week. There are no meds, doses, or health claims printed here; it is an organizer for whatever the label and the doctor already said.
How to use this page: print it, copy each med name and the dose exactly as written on the pharmacy label, and post the sheet where the pills live. Circle or tick the day's dot after each slot is handled. When a doctor or pharmacist changes anything, cross out the old line, write the new one, and put the date next to it. For anything about what a medication is or how much to take, the label and the prescriber's office are the source; this chart only tracks what was done.
Five slots cover a full day: morning, midday, evening, bedtime, and as-needed. Each slot has two write-in columns (med name, dose) and seven circles, one per day. Fill the med column from the label, not from memory. If a slot is empty on some days, leave the circles blank; an unfilled slot says something too.
| Slot | Med (from label) | Dose (from label) | Mon | Tue | Wed | Thu | Fri | Sat | Sun |
|---|---|---|---|---|---|---|---|---|---|
| Morning | |||||||||
| Midday | |||||||||
| Evening | |||||||||
| Bedtime | |||||||||
| As needed |
If two meds share a slot, write both on the line, or print a second sheet and label the slot. The as-needed row is worth keeping even when it is mostly empty: it shows the doctor how often the "when you need it" item actually comes up.
One box, three facts, so nobody hunts through a wallet for the phone number at refill time. The refill date is printed on the label or the bag; copy it here.
Pharmacy name:
Phone: Refill date:
Refills sneak up on people because every med runs out on a different week. Write each med's next refill date here and tick picked when the bag is actually in the house. The first row is a worked example; overwrite it with your own.
| Med | Refill due | Picked |
|---|---|---|
| Example: blood pressure med | Sep 14 | |
One habit covers this whole table: when you pick up any refill, write the next due date the same minute, before the bag gets put away.
Opinions from one household notebook to another:
Questions arrive at strange hours and leave before the appointment. Keep the box on the same clipboard as the chart and write them down as they come. Four lines, one question each; the front of the line goes to whichever question has been waiting longest.
This chart is one page of the Senior Care & Legacy Binder system, which also includes a 20-row medication log with change history, a 15-row medical contact hub, daily care notes, appointment and insurance logs, a 25-point home safety checklist, and the legacy planning pages. If the schedule here is doing its job, the full binder gives the rest of the paperwork the same treatment. For the longer-horizon side, see the end-of-life planning checklist.
Full 28-page Senior Care & Legacy Binder, A4 + US Letter →one-time · instant download · print copies for your own household
This page is a household organizer, not medical advice. It contains no medication names, no doses, and no health guidance, and it is not a substitute for the pharmacy label or the instructions of a doctor, pharmacist, or care team. Copy med names and doses only from the label, and direct every question about medicines to the prescriber or pharmacist.