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Module 9

Medication Risk-Benefit Worksheet

Structured framework for making informed medication decisions with your doctor

Medication Details

Medication Name

Condition Being Treated

How long has this condition been present?

Prescribing Doctor


Benefits Assessment

What specific symptoms should this medication improve?

How will we know it's working? (measurable indicators)

Expected timeline to see results


Risks Assessment

Known side effects (from prescriber + your own research)

Long-term effects (if known)

Interactions with current medications or supplements


Alternatives Considered

Non-medication approaches tried and results

Other medications considered and why they were ruled out


Questions to Ask the Prescriber

  1. 1What happens if we don't start this medication right now?
  2. 2What's the lowest effective dose we can start with?

How to Use This Worksheet

How to use this: Before your pediatrician appointment, fill in what you know. Bring it with you and use it as a conversation guide — not a decision tool. The final decision should always be made with your doctor.

Medication Journal

Keep a medication journal. Track mood, sleep, appetite, behavior, and side effects daily for the first 2-4 weeks. Bring it to follow-up appointments — it's more reliable than memory.

Important

This worksheet is a conversation tool, not a substitute for medical advice. Never start, stop, or adjust a prescribed medication without consulting your child's healthcare provider.

Next Steps

Next Steps: After your appointment, use the Medication Interaction Checker Template to document everything your child takes. If you're exploring alternatives, review the Common Childhood Medication Alternatives Chart to discuss options with your doctor.

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