Healthcare Proxy & Medication Form

This is a resource with forms and links you may need as a patient of MelroseWakefield Healthcare.

Healthcare Proxy

A healthcare proxy should be established so that your “healthcare agent” can make medical decisions for you if you become incapable of making your own medical decisions (e.g. due to unconsciousness, dementia or other mental limitations).

Medication Form

Medication errors can be prevented if your medication records are accurate, up-to-date and accessible to your physician. Since it’s not always easy to remember what medications you are taking, we are providing you with a framework for listing your medications before you come for your visit or surgery.

CURRENT MEDICATION LIST