Geriatric Medication Refill Request with Anticholinergic Burden Assessment

Optimize Medication Safety for Older Adults with Paperform

Managing medication refills for geriatric patients requires more than just processing requests—it demands careful screening for anticholinergic burden, attention to Beers Criteria, and proactive deprescribing protocols. This Geriatric Medication Refill Request with Anticholinergic Burden Assessment template is designed specifically for geriatric clinics, senior care facilities, and pharmacies serving older adults.

This form streamlines the refill process while integrating critical safety checkpoints. It captures essential patient information, current medication lists, and conducts Beers Criteria screening to identify potentially inappropriate medications for older adults. The built-in anticholinergic burden assessment helps clinicians evaluate cumulative risks that can lead to cognitive impairment, falls, and other adverse outcomes.

Why Paperform for Geriatric Medication Management?

Paperform makes it easy for healthcare teams to create patient-friendly forms that work seamlessly within existing workflows. With conditional logic, you can automatically route high-risk cases to geriatric pharmacists for consultation, trigger deprescribing protocols when appropriate, and ensure every refill request receives the clinical oversight it deserves.

Connect submissions directly to your EHR system, send automated follow-up emails to patients and caregivers, or use Stepper (stepper.io) to build complete medication management workflows—from initial screening through pharmacy consultation, prescriber review, and patient education. All while maintaining SOC 2 Type II compliance and GDPR standards that healthcare organizations require.

This template helps geriatric care teams reduce polypharmacy risks, improve medication appropriateness, and deliver safer, more coordinated care to older adults—all through one intelligent, easy-to-use form.