Medication Reconciliation Form

Medication errors during care transitions are one of the most common preventable patient safety issues in healthcare. This Medication Reconciliation Form helps healthcare facilities create a complete, accurate record of all medications a patient is taking as they move between care settings—from home to hospital, hospital to skilled nursing, or hospital to home.

Built for hospitals, clinics, rehabilitation centers, and transitional care coordinators, this form template streamlines the medication reconciliation process by capturing home medication lists, hospital medications administered during the stay, and discharge prescriptions in one organized workflow. It helps identify discrepancies, prevent duplicate therapies, and ensure nothing falls through the cracks during handoffs.

With Paperform's conditional logic and calculation features, you can automatically flag potential drug interactions, missing doses, or mismatched medications between lists. The form can be filled out collaboratively by pharmacists, nurses, and physicians, then shared with patients and their families as part of discharge education.

Use Stepper to automate what happens after submission: route reconciliation reports to the care team, trigger follow-up appointment reminders, update electronic health records, and send alerts when high-risk medications require monitoring. You can also use Papersign to collect patient acknowledgment signatures on discharge medication instructions, creating a secure audit trail.

This form is ideal for healthcare administrators, clinical pharmacists, discharge planners, and care transition teams working to meet Joint Commission standards and reduce readmissions caused by medication errors.