Caregiver Binder

What’s inside

32 pages in each PDF

1. Cover with fill-in lines for the person's name, who keeps the binder and a phone number1 page
2. Start here: every page with its page number in the file, and how to print and fill in1 page
3. Emergency information for the fridge: name, date of birth, address, languages and communication, conditions, allergies, doctors and pharmacy with phone numbers, two people to call, insurance, and where the binder is kept1 page
4. Phone numbers: 15 lines for a name, who they are and a phone number1 page
5. About me, for a hospital or respite stay: what matters to me, how I communicate, things that worry or upset me, what helps me, my routines, food and drink1 page
6. Daily care log, one page a day: meals and drinks, medicines given with a tick box for morning, midday, evening and night, toilet, washing and dressing, activities and visitors, mood, sleep, naps and notes1 page
7. Appointments: 15 lines for the date, time, who and where, and what for1 page
8. Before a doctor visit: the reason for the visit, changes since the last visit and 4 questions to ask1 page
9. During and after a doctor visit: notes, what was decided and the next appointment1 page
10. Questions for the doctor: 9 questions with room for the answers1 page
11. Pain and symptoms: a 0 to 10 line to circle, where it is, when it started, what makes it better or worse, and notes1 page
12. Large-Print Medication List and Log, whole: a medication list of 14 lines, stopped medications, vitamins and supplements, a daily medication log to tick (Monday or Sunday start) and folding wallet cards, with its own start page, license and note10 pages
13. Large-Print Blood Pressure Log, whole: weekly logs with morning and evening rows (Monday or Sunday start), an undated log, a monthly log for days 1 to 31 and a notes page, with its own start page, license and note9 pages
14. Personal-use license and about these pages2 pages

How it works

1. Type before you print, in the free Adobe Acrobat Reader, or print the pages and write by hand. Long names shrink to fit.
2. Type the person's name once: it fills in on the cover, the emergency page, the about me page, the daily care log, the before a visit page and the pain page. The medication list and the blood pressure log have their own name line.
3. Print the daily care log, the visit pages and the logs as often as you need.
4. Keep the pages in a three-ring binder, with a copy of the emergency page on the fridge.

Sizes and format

• 2 PDF files: US Letter (8.5 x 11 in) and A4, 32 pages each
• Large print: page titles 26 pt, labels on the binder pages 18 pt, column headings in the logs 14 to 16 pt (the wallet cards are smaller)
• The fill-in fields and tick boxes need the free Adobe Acrobat Reader
• Blank forms, text and lines only: no illustrations, no chart of ranges, no doses, no advice
• The medication list and the blood pressure log keep their own page numbers, as in their own listings
• Instant download. No physical item is shipped.

The files

• US LetterPDF, 32 pages, 1.1 MB
• A4PDF, 32 pages, 1.1 MB

Your license

For personal use in one household: print as many copies as you need, and please don't share or resell the files.