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Medical Manager


                          Always try to keep your medical information updated.
                             You can print this and use as a template.
Current Medical Problems :[eg: hypertension, diabetes, cholesterol]
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Past Medical History : [eg: pneumonia, stroke, coronary artery disease]
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Previous Surgical Procedures : [eg: appendix, gallbladder]
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Current Medications plus dose and frequency : 
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Drug Allergies :[eg: penicillin, sulfa]
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Other Allergies : [eg : pollen, ragweed, latex]
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Family Medical History : [eg : colon cancer, breast cancer, diabetes, stroke, heart disease]
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  •  Parents, grandparents and siblings        
Immunization History : [eg: tetanus, pneumonia]
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Test Results : [eg: cholesterol, complete blood count]
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Major Studies : [eg: stress test, colonoscopy, mammogram]
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My measurable data : [Age, Height, Weight, Blood Pressure, Cholesterol levels]
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My health care proxy is:                           tel:

My emergency contact is:                         tel: 

My wishes with regard to resuscitation and life support are:

My wishes with regard to organ donation are:

My pharmacy telephone number is:

My doctor is:                          tel:              ann. exam month:

My ob/gyn is:                        tel:              ann. exam month:

My eye doc. is:                       tel:              ann. exam month:  

My health insurance is:                                              number:

 

Reminders:

  • Immunizations (tetanus booster every 10 years; annual flu shot; pneumonia vaccine at age 65; shingles vaccine at age 60)
  • Pap smear (start at 21 and then every 1-2 years depending on type of smear test done)
  • Mammogram (baseline at age 40 and then annually from age 50, but family history must be taken into account)
  • Bone density  (baseline when at menopause, but definitely at age 65 and then repeat every two years)
  • Colonoscopy (baseline at age 50 if no family history of colon cancer). No screening after age 75.
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                                        Tracking Your Health

Some websites let patients enter daily health data and observations and provide useful feedback that can be shared with doctors:

  • TheCarrot.com: Online journal lets users track 30-plus health factors including weight, food intake, energy level and exercise and input data from an iPhone. Produces reports that track factors together, such as exercise and mood.
  • PatientsLikeMe.com: Offers surveys about diseases, conditions, treatments and symptoms. Users can chart health over time and compare progress to patients with similar conditions.
  • MyPyramidTracker.gov: Government-sponsored site lets users enter dietary information and exercise. Provides picture of food intake vs. activity level for several days or up to a year. Compares daily dietary information and exercise to current guidelines.
  • Keas.com: Offers tools to track personal data and health plans to manage weight, chronic conditions, depression or pregnancy. Users can sign up for condition-specific care plans such as headaches and keep diaries on headache triggers.
  • RevolutionHealth.com: Provides health trackers for blood pressure, blood sugar, pregnancy weight gain, pregnancy temperature, exercise.
  • Baby-Connect.com: Lets authorized users on iPhones, iPads, iPods or website track daily information on infants including food intake, diaper changes, sleep, mood, growth milestones, medications and vaccines.
  • HealthButler.com: Preventive health information service lets users track healthy habits and compliance with preventive health measures over time; links screening and preventive history to Google Health personal profile