1 1 home
Caregiving > Resources for Giving Care

The Caregiver Notebook

Keep track of the health information of the person in your care.

  • Caregiver
    Download The Caregiver Notebook.

    Or if you're on a mobile device, email the notebook to yourself and you can fill it in later.

You can fill in your loved one’s information from your computer using the form fields provided, or you can print it out and fill it out by hand.

General medical information

Use this form to jot down your loved one’s important details, like his or her address, phone number, and insurance information. Make sure to include other details that could be important in case of emergency, such as medical conditions, allergies, and dietary restrictions.

What to do in an emergency

Make a detailed list of all of your loved one’s emergency contact information. Suggestions for how to handle emergencies can also be included.

Health care providers

Record the contact information for all of your loved one’s medical providers, pharmacies, and preferred medical facilities.

What the doctor needs to know

Create a list of names and phone numbers of doctors. Don’t forget to include physical therapists, nutritionists, or other specialists the person in your care may see. If multiple people are managing his or her care, create a copy of the list for everyone to keep on hand.

Prescription and over-the-counter medicines

Use this form to jot down the details of any prescription or over-the-counter medicines your loved one is using, and the health condition for which they are used.

Vitamins, supplements, and herbals

Write down the names of any vitamins, supplements, or herbals that your loved one is taking and the health condition for which they were prescribed. If he or she stops taking a vitamin, supplement, or herbal, simply write down the reason in the space provided.

Important paperwork

Keep your loved one’s driver’s license and insurance information easily available. Make sure to also record where important documents are stored, like insurance forms, wills and trusts, advanced directives, and do-not-resuscitate paperwork.

Daily routine

Use this form to jot down the details of routines, limitations, and needs of the person in your care.

Medical costs tracker

Account for your loved one’s expenses, recording the date and type of service, the total bill, and the out-of-pocket costs.

Notes

This space can be used to record any additional information you may need.

  • Caregiver
    Download The Caregiver Notebook.

    Or if you're on a mobile device, email the notebook to yourself and you can fill it in later.