What should I include when putting together my health history? What sorts of things should I keep track of? Here are guidelines to follow when writing out a health history.
See also: Assessing the Situation.
- This section should go at the beginning and should include:
- Name of patient, date of birth, address and phone numbers.
- Family doctor’s name and telephone number.
- Information on health insurance company, including member and group identification numbers, as well as address and phone number.
- Medicare and/or Medicaid number.
- Pharmacy name and telephone number.
- Emergency contact name and telephone number.
- Nearest hospital name and telephone number.
- Blood type.
- Allergies to drugs, foods, insects, etc.
- Special conditions, such as being diabetic, epileptic or having a pacemaker.
- Whether a living will or health care proxy exists.
Health Care Providers
List the names of all providers, their specialties, their telephone numbers and the conditions they’re treating.
- Primary care physician/geriatrician.
- Eye doctor.
- Ear, nose and throat specialist.
- Foot doctor.
- Heart specialist.
- Cancer specialist.
- Orthopedist (specializes in bone, joint and muscle problems).
- Gastroenterologist (specializes in diseases of the digestive tract).
- Endocrinologist (specializes in diseases of the glands).
- Urologist (specializes in diseases of the urinary tract and male reproductive organs).
- Psychologist or social worker.
- Physical therapist.
- Nutritionist or dietitian.
- Visiting nurse.
- Home-care aide.
List all prescribed medications, the reason they were prescribed and the prescribing doctors. Include the start date and dosage. Any vitamins, herbs, supplements or over-the-counter medicines taken regularly should be included.
Download this personal medication record to help you track your loved one's medicines.