GBMC HEALTHCARE 6701 North Charles Street Baltimore MD - gbmc-2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the patient's home medication details recorded on admission. Fill in the 'Documented by' field with your name, and specify the 'Date' and 'Time' of documentation.
3. In the medication section, list each medication, herbal supplement, vitamin, contrast agent, or over-the-counter drug. For each entry, provide the 'NAME', 'DOSE', 'REASON', and 'LAST TAKEN'. Ensure accuracy for effective medication reconciliation.
4. Next, document any allergies or adverse reactions. Specify the 'TYPE', 'SEVERITY', and 'DATE' of each reaction to ensure comprehensive patient safety.
5. Finally, have the form reviewed by the Attending of Record or Designee. Fill in their name along with the corresponding date and time for admission, change in level of care, and discharge.

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