Vitamin or Mineral	✓Box if Taking	Date Started (mm/yyyy)	Dose	Unit	Frequency
Ex: Calcium	✓	10/2008	1000	mg	once a day
Multivitamin			N/A	N/A
Vitamin A				IU
Beta carotene				IU
Vitamin B1 (thiamine)				mg
Vitamin B2 (riboflavin)				mg
Vitamin B6 (pyridoxine)				mg
Vitamin B12 (cyanocobalamin)				mcg
Biotin				mcg
Vitamin C (ascorbic acid)				mg
Vitamin D (calciferol)				IU
Vitamin E (tocopherol)				IU
Folic acid/folate (folacin)				mcg
Niacin (niacinamide)				mg
Pantothenic acid (pantothenate)				mg
Calcium or Tums				mg
Chromium				mcg
Iron				mg
Magnesium				mg
Selenium				mcg
Potassium				mg
Zinc				mg