Customize template

This professional medication administration record template allows easy customization with a friendly drag and drop editor. No coding is necessary, just edit the field labels, upload your healthcare facility’s logo and brand identity, add more fields, a Comments section or an e-signature box. You can also make your form HIPAA-compliant with just a few clicks.

Publish template

After editing this medication record sample, we offer quick ways of publishing it anywhere online with no effort at all. Embed the form on your website with the classical copy-paste or share the form URL privately with your medical staff on email or an internal network. And since we are all mobile these days, our forms are flexible so that your patients can fill them directly on their phones.

Collect & manage data

This sample medication administration record offers you a friendly procedure to securely store sensitive medical data. From our platform, you can update or manage data entries in any desired way. Exporting them is available in Excel, CSV or PDF format, and we also provide multiple web app integrations to save you even more time and effort in handling medical information.

Optimize your flow

Each time a patient will complete this medication administration record form, you will be instantly notified by email or SMS. Say goodbye to endless paperwork and start using digital forms today. You just need to sign up on the 123FormBuilder platform. Our intuitive tool will help you get more done in less time. Automation is the key to keep secure medication administration records and speed up the data collection process.