Family Voices of Alabama developed a Care Notebook through its Family-to-Family Health Information Center project. It provides a framework with easily fillable forms for creating your own Care Notebook.

Based on our research and experience, we have tried to include the best ideas to help you simplify a difficult task.

Order a Notebook.
If you would like to order a free Care Notebook, or any other resources, please complete the Request Information Form.

Print a Notebook or Part of a Notebook.
You can print the entire Care Notebook or individual pages in the download section below.

More Information.
Be sure to read through this helpful information below:

• How to Use Your Care Notebook
• How Do I Set Up My Child's Complete Care Notebook?
    

We want your Comments

Hear what one of our clients had to say about our Care Notebook

If you have used the Care Notebook, we want to hear from you. How useful was it? Do you have suggestions to make it better? Please complete a short survey to help us improve our services.

Care Notebook Feedback Survey

  

Download your Care Notebook (PDF Files)

  

2 - Or you can download only those pages you need using the list below.

Fill in the forms and save them with your information to your computer so you can easily update them in the future. You will need the free Adobe Reader* to view and edit the pages. Links to the PDF version of each page are listed below.

Care Notebook

• Care Notebook Cover
• Care Notebook Table of Contents

Tab #1- Family Information

• Family Information
• Family Health History
• Insurance Information
• Family Support Resources
• Child's Profile: Getting to Know Me

  
Tab #2- Emergency Information

• Emergency Information Form

Tab #3- Physician & Provider Contacts

• Primary Care Physician & Specialty Care Physician Contact Information
• Provider Contact Information (may include some or all of the following: Recreation Center, Medicaid, Therapists, Dental Care Provider, Transportation, Child Care, Home Health Care Provider, Early Intervention Services, Social services, Insurance Case manager, Clinic coordinator, Respite Care, Durable Medical Equipment Provider)
    

Tab #4- Records of Medical Care

• Doctor's Visit Notes
• Equipment List
• Supplies List
• Surgeries and Procedures Tracking Form
• Hospital Admissions (for reasons other than surgery)
• Medication Management Form
• Diet Tracking Form & Nutrition Notes Tracking Form
• Growth Tracking Form
• Tests Results Log (include records of blood or urine tests, X-rays, etc.)
    

Tab #5- Personal Notes & Planning

• Appointment & Questions Log
• Record of Medical Expenses Form (We recommend that you purchase a plastic storage page to keep track of copies of correspondence including appointment letters, insurance referral authorization letters, etc.)
    

How to Use your Care Notebook

• Guidelines and advice

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How to Use your Care Notebook

Being the parent of a child with special health care needs can feel overwhelming at times. Your child may need care and services, on a regular basis, from many different types of providers. This Care Notebook was designed to help you maintain an ongoing record of your child's care, services, providers, and notes. It is also a way to maintain the lines of communication between the many service providers that help care for a your child and family.

How Do I Set Up My Child's Complete Care Notebook?

Care Notebooks are designed for a 3-ring binder or other notebook which you can easily add and remove pages.

Care Notebooks are very personal to your child and should be customized to reflect your child's medical history and current information. Remove pages that are not useful to you and your child.

Gather information you already have about your child's health. This may include reports from recent doctor's visits, a recent summary of a hospital stay, names and phone numbers of physicians, hospitals, and relatives, or test results. Store business cards in a plastic holder you can insert after Tab #3.

Decide which information about your child is most important to keep in the Care Notebook and file it in the appropriate section.

UPDATE the Care Notebook regularly. Extra copies of Care Notebook pages will be available for download from the Family Voices of Alabama website www.familyvoicesal.org.

ADD information to the Notebook as it becomes available. For example, if you receive new information from health care providers, update the appropriate Care Notebook pages. If tests results are available electronically, request a DVD to store in the provided holder just after Tab #4. Keep track of your child's condition(s) on a regular basis including updating medication changes. Log phone conversations with providers using either the "Doctor's Visit Notes" (found within Tab #4 section) or the "Appointment & Questions Log" (found within Tab #5 section).

Track expenses related to your child's care. Store receipts, bills, etc. in a clear pocket you can add in the back of the Care Notebook. This is especially useful to track out-of-pocket expenses for tax purposes.

 

Please consider starting to do planning for the future with our

Transition to Adult Health Care Guide (pdf)

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* You will need the free Adobe Reader software to open these files. If you do not have it, get more information on our software page.

Can't find what you need?

We hope you find what you need.

If not, please Contact Us and we will do our best to assist you!

DISCLAIMER: Within this web site, there are links to "outside sites" which are not managed by the Family Voices of Alabama (FV of AL).  FV of AL does not endorse nor recommend the information or products posted on these sites, and receives no payment or other consideration for providing these links.