Caregiver Daily Log Book
$5 $10
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Features:
Personal information (name, nickname, address, phone#, gender, date of birth)
Emergency contacts
Important information (preferred hospital, police, fire department, utilities & services)
Insurance information (insurance company, plan type, policyholder, group #, ID #, phone #, website, username, password)
Pharmacy information (name, pick up or delivery, location, phone #, fax #, website, user name, password)
Physician(s) information (name, address, phone #, website, username, password)
Primary doctor
Dentist
Specialists
Medical history (blood group, height, weight, BMI, allergies, major illnesses, surgeries)
Family medical history (medical condition, with space to write your own), family members with that condition)
Medication list (name of medication, dose, time, purpose)
Diet restrictions (food type, reason)
Notes
Daily log
Name, wakeup, bedtime, up at night
Date, day of the week, rating
pain level, mood, energy level
meals (time, food, water/drinks, medication(s) for breakfast, AM snack, lunch, PM snack, dinner)
Personal care (self, with help, caregiver with checkboxes)
Physical therapy (with checkboxes)
Toilet (time, results (wet or BM)
Appointments
Activities
Pain/health concerns
Visitors (time, name, purpose of visit)
Housekeeping (with checkboxes, space to write your own)
Supplies needed
Notes
Dimensions: 8.5 x 11 in.
120 pages
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