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• Patient and Visitor Guide:
Kaweah Delta Health Care District Includes:

• Kaweah Delta Medical Center
• Kaweah Delta Rehabilitation Hospital
• Kaweah Delta Mental Health Hospital
• Kaweah Delta Imaging Center
• Kaweah Delta Exeter Health Clinic
• Kaweah Delta Urgent Care
• Kaweah Delta Visalia Dialysis
• Kaweah Delta Porterville Dialysis
• Kaweah Delta Hospice
• Kaweah Delta Sleep Disorders Center
• The Lifestyle Center

and maintains partnerships with:

• Cypress Surgery Center
• Quail Park Retirement Village
• Sequoia Regional Cancer Center

Med Form

* En Español

Download The Med Form

The Med Form helps you and your family members track medications you are taking from prescription to over-the-counter herbals and vitamins. This document is designed to provide physicians and others with a current list of all of your medicines. By sharing The Med Form with their providers, patients become active participants in the healthcare team.

Instructions for the The Med Form:


  • Keep The Med Form with you at all times, in case of a medical emergency.
  • Take The Med Form with you to all doctor and other healthcare provider visits (e.g., nurse practitioner or dietitian).
  • Write down all of the medicines you are taking, including over-the-counter medications such as vitamins, herbals and others.
  • Include the name of the doctor who prescribed the medication. You may also write why you are taking the medicine (e.g., high blood pressure, high blood sugar, high cholesterol). If you are not sure why you are taking the medication please write don't know.
  • When you are discharged from the hospital, someone will speak with you about which medicines to take and which medicines to stop taking. Because patient medications often are changed during hospitalization, it's important that you complete a new Med Form. Take the new form to all doctor visits following your hospitalization to discuss it with him or her.
  • Remember to update your Med Form when your doctor changes, stops or updates your medication.

Why The Med Form?


The Med Form will:

  • Help you and your family members remember all of the medications you are taking;
  • Provide your doctor(s) and other healthcare providers a current list of all medicines, including over-the-counter medicines, vitamins and herbals; and
  • Detect concerns about medicines by including a comprehensive listing of medications for your healthcare team.