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» LymeNet Flash » Questions and Discussion » General Support » Template for good sheet to take to doctor

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Author Topic: Template for good sheet to take to doctor
Ann-OH
Frequent Contributor (5K+ posts)
Member # 2020

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Your Name,address,phone number,date of birth

Spouse or significant other + phone number

Emergency contacts + phone numbers - include all people you want be contacted

Today's date:

Current medications: (as of current date)
Prescription


Non-prescription (over the counter, plus herbs and vitamins)

Immunizations (tetanus, flu, etc.)

Recent procedures (mammogram, colonoscopy, etc.). - name and date of each,

Surgeries (reason and date)

Allergy to medications
"I have shown negative reactions to the following medications":
List medication, date, and your specific bad reaction to each.

Recent Medical Problems:
List problem and date of onset to date cured, or to current date and what remedy was used.
(example: back injury 4-04,chiropracter to now)


Primary Physician: Name, Phone & Fax numbers
Specialists: names with phone and fax numbers
Dentist: name, phone and fax numbers
Primary Insurance: name and ID number
Secondary Insurance: Name and ID number
Power of Attorney: name and phone number
Living Will: (how to get that info)

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Posts: 5705 | From Ohio | Registered: Jan 2002  |  IP: Logged | Report this post to a Moderator
Ann-OH
Frequent Contributor (5K+ posts)
Member # 2020

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I manage to get all this info on a single sheet by adjusting the borders of the page and using size 10 font. You could print on both sides of the page if you need to.

I make and carry one in my wallet, one in my address book, and one in my folder that I carry to all doctor visits. Staff can make a copy and have all the answers they need. Make sure they put it in your file.

I got a really cool plastic spiral folder one that has several sheets with pockets - very sturdy - I can have a different place with pocket for each doc. with her card and handouts and prescriptions.

I also found a manilla file folder with those long clasp thingies at the top of each side. I punch holes in any report or test and file them all in that on the right side with the handouts on any drugs I take on the left side. Then I can carry that with me, tucked inside the plastic folder.

Sounds complicated, but it is really easy and works well.

I also carry a medium size spiral notebook which is my journal of any visits and changes.

I write out my questions and replies on the left side and put answers to my questions plus any prescription info on that side.

Date, doctor, symptoms and reasons for visit etc. go on the right side. Doctors are much more likely to make everything clear when they see you taking notes. If you can, take someone with you, especially to the first visit. They can take notes too.

All this is really great documentation if you ever have to apply for help.You can update your info sheet on the computer for every visit. Cool!

A tote bag for all this stuff might help too.I seem to manage without one.

Hope this is helpful.
Ann- OH

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Keebler
Honored Contributor (25K+ posts)
Member # 12673

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Good suggestions, Ann.

Here's a thread to complement this one:

http://flash.lymenet.org/scripts/ultimatebb.cgi?ubb=get_topic;f=1;t=020605

MAKING THE MOST OF YOUR LLMD VISIT

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Ann-OH
Frequent Contributor (5K+ posts)
Member # 2020

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Thanks, Keebler.
If you go to the website she gives you above, you will find Melanie's ideas. and be sure to scroll down for wonderful list of sources from Keebler.

The more you know, the more you are in control of beating these infections.

Ann - OH

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Posts: 5705 | From Ohio | Registered: Jan 2002  |  IP: Logged | Report this post to a Moderator
   

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