Personal
Prevention Charts
Ask your health care provider
how often you need each type of care and the goal you should reach. Then
write down the information in the charts below.
Also, write down the
date and results of the care you get or ask your doctor to write down this
information.
Try to remember to bring
the charts with you each time you see a health care provider. These charts
will help you keep track of when you need your next test or checkup and
will help you keep track of the medicines you are taking.
Ask your doctor or other
health care provider how often you need each kind of test. Then write down
this information in this record.
Ask your doctor to write
down the date you receive the tests and the results. Try to remember to
bring the booklet with you each time you see a doctor. This record will
also help you keep track of when you need your next test or checkup.
Write down the date
you receive each immunization (shot).
Write down the name
of each medicine you take, the reason you take it, and how you take it,
in the spaces below. Add new medicines when you get them. You can show
the list to your health care provider and pharmacist. You may want to make
copies of the blank form so you can use it again.
The U.S. Preventive
Services Task Force—a panel of private-sector experts in primary health
care and prevention convened by the Agency for Healthcare Research and
Quality (AHRQ)—has found that some tests that doctors perform have not
been proven effective for healthy, average-risk persons.
These tests include
the PSA test for prostate cancer, blood tests or ultrasound for ovarian
cancer, chest x-ray for lung cancer, urine tests for bladder cancer, routine
blood tests for anemia, routine urine tests, and routine electrocardiogram
or stress tests for heart disease for people without symptoms.
If your doctor or health
care provider recommends any of these tests, you may want to ask why you
need them. Talk to your doctor or other health professional about what
is right for you.
Charts
To use the charts, select
the links below and then print out the charts from your browser (File/Print).
Personal
Information Chart
Personal
Prevention Chart
Cancer
Test Chart
Flu
Shot Chart
Tetanus
Shot Chart
Pneumonia
Shot Chart
Medicine
Chart
 Previous
Section Contents
Internet
Citation:
Staying
Healthy at 50+. Agency for Healthcare Research and Quality, Rockville,
MD. AHRQ Pub. No. 00-0002, January 2000. http://www.ahrq.gov/ppip/50plus/index.html
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