Acute Disseminated Encephalomyelitis (ADEM) Support Group

Medical Forms and Trackers


#1

Thanks to Renie, moderator of LWTN, for sharing the links of the basic forms and worksheets that can help you organize your medical information and also prepare for a doctor visit.

Here's the list:

38-Doctor_Visit_Preparation_Sheet.pdf (55.8 KB)

39-Medical_History.pdf (59.6 KB)

40-Medication_Log.pdf (72.3 KB)

41-Allergy_Tracker.pdf (78.7 KB)

42-Surgical_History_Record.pdf (72.5 KB)

43-Family_Medical_History_Form.pdf (84.5 KB)

44-Pain_Tracker.pdf (32.7 KB)

45-Sleep_Diary_Adult.pdf (128.3 KB)

46-Physical_Activity_Tracker.pdf (142.7 KB)

47-Mood_Tracker.pdf (70.6 KB)

48-Blood_Sugar_Tracker.pdf (103.7 KB)

49-Blood_Pressure_Chart.pdf (50.6 KB)

50-Walletsized_Medical_Information_Card.pdf (68.9 KB)

51-Health_Information_Release_Authorization_Form.pdf (192.0 KB)

52-hipaafaxcoversheet.doc (50.5 KB)

53-Medical_Bill_And_Expenses_Tracker.pdf (89.8 KB)