EFTA00314173.pdf
dataset_9 pdf 277.2 KB • Feb 3, 2026 • 1 pages
III
PRIORITY PRIVATE CARE
MEDICATIONS
Please list prescriptions and non-prescription medicines, vitamins,
herbs, etc. that you take, as well as the dose taken and how many times
taken per day.
Identify all Prescription Medications you take, dosage and how
often (frequency)
Identify all Over-the-Counter Medications you take, dosage and
how often (frequency). Be sure to include all vitamins
170 East 77th Street, New York, NY 10075 646.535.8939 priorityprivatecare.com
EFTA00314173
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- Feb 3, 2026