Printable Pharmacy Refill Tracker — Prior Authorization & Medication Refill Planner

Pharmacy refill calls shouldn't take this much energy. This sheet makes sure you're ready.

This printable pharmacy refill tracker gives you a structured place to manage every refill — calls made, prior authorizations needed, shortage issues, and pickup plans. Because running out of a critical medication isn't an option.

Designed for patients and caregivers managing multiple prescriptions, specialty medications, prior authorization requirements, or the constant coordination that complex medication regimens require.

What it helps you organize:

• Medication name, pharmacy, and prescriber
• Refill date, days supply, and when to reorder
• Prior authorization status and expiration
• Shortage notes — alternatives discussed, timeline
• Calls made, who you spoke to, and what was resolved
• Pickup plan and next refill date

What you get:

• Printable PDF — instant digital download
• US Letter size (8.5 × 11 in)
• Black and white — prints on any home printer
• Print as many copies as you need

Organizational and tracking tool only. Not medical advice. Always share information with your licensed provider. DopaSheets — Simple systems for complicated days.