Your life. Your plan.
What has changed in my health?
A communication record to help explain a concern. It is not a clinical score or emergency plan. Do not delay medical help to complete it.
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What I am saying or showing
My own words, signs, pictures or changes someone has noticed.
What is usual for me
Relevant communication, comfort, activities and support.
What changed and when
Describe observations and times. Say what you do not know.
Useful health information
Relevant conditions, medicines, allergies and my existing plans.
Who we contacted and the advice
Name or service, date and time, what was agreed and who will act.
Next contact and review
When will someone respond? What did the clinician say to do if things change?