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AARP-Walgreens Alliance

"Your Medicines and You" Order Form

Select each item you would like. One copy of each selection will be sent free of charge. Please allow 2 to 4 weeks for delivery.

   
Personal Medication Record (D18589)
Registro de Medicación (D18594)
The best way to track medications and help your doctor, pharmacist, or other healthcare professional is to keep a medications list, or "personal medication record" (PMR). AARP has made it easy with this form that will help you record all the medicines, including prescription and over-the-counter drugs and dietary supplements that you take, the doses, and how they are taken.
   
Medicines Made Easy (D18586)
Medicamentos En Lenguaje Facil (D18593)
This comprehensive and easy-to-understand free booklet contains loads of important information on how to safely and effectively manage, use, and store your medicines. Read the must-ask list of questions for your health care provider and pharmacist to get information on drug interactions, generics, and side effects. And discover drug options that may save you money.
   
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* Phone:  (e.g. 202-555-4321)
* Street Address (No P.O. Box):
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* State:
* Zip/Postal Code:

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