SafetyRX - Safety PassportRx

Built for families who need clarity, not medical jargon.

Family Caregivers

For adult children, spouses, and caregivers helping someone manage several medications.

Multiple medications

Especially when prescriptions come from different doctors, clinics, or pharmacies

Side effect concerns

When symptoms appear after a new medication, dose change, or refill change.

How the founding
pilot works

The first 25 selected families will receive a structured medication safety review designed to help them better understand whether multiple medications, recent changes, possible interactions, or expected side effects could be contributing to what they are seeing.

Apply

Tell us what is worrying you, what changed recently, and how many medications your loved one is taking.

Organize

If selected, we request medication details and organize the concern into a structured review.

Discuss

You receive plain-English watch items and questions to raise with a doctor or pharmacist.

Apply for the Safety PassportRX founding pilot

This short intake helps us understand whether Safety PassportRX is a good fit and whether the situation may need urgent medical attention.

Your name *

Email *

Phone number *

Relationship to loved one *

Loved one's age *

Any recent medication change? *

“How many prescription medications? *

How many doctors/clinics prescribe medications? *

What concerns are you seeing?

Dizziness or lightheadedness

Confusion, memory, or behavior changes

Falls, balance problems, or weakness

Fatigue or unusual sleepiness

Sleep changes or agitation

Nausea, appetite, bowel or stomach issues

New pain, tremors, or movement changes

Other concerns

What is worrying you most right now?

Can you provide a medication list or photos of medication bottles if selected? *

Disclaimer *

Safety PassportRX provides organization, education, and medication-safety discussion support. It does not provide medical diagnosis, emergency care, or treatment. Do not stop, start, or change any medication without guidance from a licensed clinician.

If symptoms are sudden, severe, worsening, or life-threatening, call 911 or seek urgent medical care.

Acknowledgement *

I understand this is an application for educational medication-safety support and is not medical care, diagnosis, or emergency service.

Thank you. Your Safety PassportRX founding pilot application has been received. If the situation appears appropriate for the pilot, we will contact you with next steps. If this is urgent or worsening, contact your doctor, pharmacist, or emergency services right away.

There was an error trying to send your message. Please try again later.

Worried a loved one's medication

may be causing problems?

Built for families who need clarity, not medical jargon.

Family Caregivers

Multiple medications

Side effect concerns

How the founding
pilot works

Apply

Organize

Discuss

Apply for the Safety PassportRX founding pilot

Worried a loved one's medication

may be causing problems?

Built for families who need clarity, not medical jargon.

Family Caregivers

Multiple medications

Side effect concerns

How the founding pilot works

Apply

Organize

Discuss

Apply for the Safety PassportRX founding pilot

How the founding
pilot works