Immediately below are the pre-course and post-course surveys. If you have not already completed these surveys, please do so now. If you have any questions about the course or these resources, please use our contact page to ask your questions.
The forms are available in two versions, Microsoft Word Doc, and a PDF. The Word doc is editable and will allow you to enter your medical information directly into the document. The PDF is meant to be printed and filled-in by hand. These forms are for your benefit. Please use them, and feel free to share them with others.
Welcome to the course resources page. Here you will find a variety of resources which will assist you in Becoming Your Child's Healthcare Advocate. In the BYCHA course, you were encouraged to create a Personal Health Record Notebook. Below you will find all the required forms and a checklist of the various items you will need to place in your notebook.
Thank you for giving us the opportunity to serve you. It is our desire to assist you in caring for your loved ones.
Peace and blessings be with you,
Patient Advocacy Forms
Personal Health Record Notebook Checklist
This document provides you with a basic checklist of the various items you will want to place in your medical notebook.
Patient & Family Medical History
This document gives you the opportunity to thoroughly document the medical history of the patient and their family.
This document allows you to list medication names, days given, strength, frequency, dosage, the purpose of the medication, and a place to write notes.
Caregivers Daily Log
This document will assists you in tracking the daily progress of your patient. Log changes, medications given, food eaten, sleep patterns, and energy levels.
Medical Appointment Notes
Use this form before, during, and after your next doctor's appointment to take notes, ask questions, and document symptoms.
Patient Healthcare & Support System Directory
Record your medical contact information in this directory. Include your doctors, hospitals, pharmacies, and your people in your support network like family, friends, and social groups you will be able to rely upon.