My Medical Chart

Take Control of your health and healthcare

Collecting and organizing important information about you and your health care is the first step towards getting the most out of your medical care. Do not rely on your health care provider to remember everything about your past treatment. Remember you are the best person to know what is most important to you personally and to advocate for yourself.

Use these links to find forms that will help you organize information important to your health care. Print these forms and update them regularly. Record important information between visits. File the forms in a care notebook. Bring this notebook to your medical visits and file new information and homework together in one place.

In this section you will find forms to store your medical history, update medication lists, set goals for your care, documents to help you prepare for medical and hospital stays, and worksheets for therapy. Let us know about a form or vital information that helps keep you or your health care provider on track (submit your idea using the contact us feature on this website).

My Medical Chart

Medical Worksheets

Airline Safety Letter
Cognitive Challenge Worksheet
Comprehensive Care Worksheet Use this worksheet to determine who should be on your medical team.
Family Physician Worksheet
Get the most Out of Your Medical Visit
Prepare for Your Hospital Stay
Sleep Hygiene
Safe Travel Summary

Lifestyle and Self -Care Management Worksheets

Are you Ready for Change?
Goal Setting:
Prioritize Your Goal Goal Setting Summary Worksheet
Wellness Worksheet

These forms may be printed for personal or educational use. The NWPF requests that you include the author and source as noted below on any printed materials distributed for educational purposes.

Author: Monique Giroux, MD

Copyright 2011 Northwest Parkinson's Foundation Wellness Center
www.nwpf.org/wellness

Medical Information Disclaimer and Legal Agreement

Please read this agreement entirely and carefully before using the Northwest Parkinson’s Foundation website (nwpf.org).By using www.nwpf.org site, you agree to be bound by the terms and conditions below and in the www.nwpf.org Privacy Policy.

Disclaimer About Medical Information:
The information and reference materials contained here are intended solely for the general information of the reader. It is not to be used for treatment purposes, but rather for discussion with the patient's own physician. The information presented here is not intended to diagnose health problems or to take the place of professional medical care. The information contained herein is neither intended to dictate what constitutes reasonable, appropriate or best care for any given health issue, nor is it intended to be used as a substitute for the independent judgment of a physician for any given health issue. All content, including text, graphics, images and information, contained on or available through this web site is for general information purposes only. The major limitation of informational resources like www.nwpf.org is the inability to take into account the unique circumstances that define the health issues of the patient. If you have persistent health problems or if you have further questions, please consult your health care provider. All visitors to this and other www.nwpf.org associated web sites agree to read and abide by the complete terms of this agreement.

Legal Disclaimers

Summary:
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Reference to any products, services, hypertext link to the third parties or other information by trade name, trademark, supplier or otherwise does not constitute or imply its endorsement, sponsorship or recommendation by www.nwpf.org or its contributors/employees. They are for convenience only.

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Links are provided only as an informational resource. Please note that many of the links provided are not on our servers and are not maintained by us or affiliated with any services provided by us. These links are provided simply as a service, and it should not be implied that we recommend, endorse or approve of any of the content at the linked site(s), nor are we responsible for their availability, accuracy or content.

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