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Use this Personal Prevention Chart to keep track of the preventive care that you have received and/or will need in the future. With the help of your health care provider, fill in how often you need each type of preventive care. Write in the date and results of tests each time you receive preventive care.
Personal Prevention Chart |
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Type of Care | How Often | Goal | Date and Results | |||||
(example) Blood Pressure |
Once a month | 130/70 | 8/12/98 140/80 |
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Blood Pressure | ||||||||
Cholesterol | ||||||||
Weight | ||||||||
Dental Visits | ||||||||
Vision |
Return to Regular
Checkups: Teeth and Gums,
Cholesterol, Oral
Cancer
Return to Personal Prevention
Charts
Return to Contents of Staying Healthy
at 50+
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