Personal medication form designed specifically for those
with diabetes. It’s free. Just download the PDF, fill in and
save securely on any device or phone. Extremely useful
when conducting tele-med consults.


Fast. Easy. Private. Accessible by you only.

Diabetes Med Pad™ (DMP) is a PDF form you download and securely store on your computer desktop or any device providing easy access to your pertinent medication and doctor information.

Never again will you have to remember the meds you’re taking just open DMP and all information is on your screen. DMP is not stored on the Internet just your personal device.

List all your medications and doctors.

Oral meds, insulins, type of syringe/pen/needles, CGM / infusion set. Add whatever meds you take to the list, even your Drs. and pharmacy.

No more guessing med names or dosage when visiting your healthcare provider. Just show your phone screen. Even forward to a family member.

No account setup. No personal info needed.

Step 1. click/tap on below to download and save DMP to any device or phone.

Meds listed in one place easily accessible.

Step 2. once DMP is saved on your device just fill in the fields and save. If filled-in on your computer, save DMP then copy to your phone if you like.

DMP is a free service of ROLACOL® an alcohol swab alternative.