Contents

Introduction

What You Can Do To Stay Healthy

Ask Your Doctor About Checkups, Tests, and Shots You Need

For More
Information

Personal Prevention Charts

Ask your health care provider how often you need each type of care and the goal you should reach. Then write down the information in the charts below. Also, write down the date and results of the care you get or ask your doctor to write down this information.

Try to remember to bring the charts with you each time you see a health care provider. These charts will help you keep track of when you need your next test or checkup and will help you keep track of the medicines you are taking.

Ask your doctor or other health care provider how often you need each kind of test. Then write down this information in this record. Ask your doctor to write down the date you receive the tests and the results. Try to remember to bring the booklet with you each time you see a doctor. This record will also help you keep track of when you need your next test or checkup.

Write down the date you receive each immunization (shot).

Write down the name of each medicine you take, the reason you take it, and how you take it, in the spaces below. Add new medicines when you get them. You can show the list to your health care provider and pharmacist. You may want to make copies of the blank form so you can use it again.

The U.S. Preventive Services Task Force—a panel of private-sector experts in primary health care and prevention convened by the Agency for Healthcare Research and Quality (AHRQ)—has found that some tests that doctors perform have not been proven effective for healthy, average-risk persons. These tests include the PSA test for prostate cancer, blood tests or ultrasound for ovarian cancer, chest x-ray for lung cancer, urine tests for bladder cancer, routine blood tests for anemia, routine urine tests, and routine electrocardiogram or stress tests for heart disease for people without symptoms.

If your doctor or health care provider recommends any of these tests, you may want to ask why you need them. Talk to your doctor or other health professional about what is right for you.

To use the charts, select the links below and then print out the charts from your browser (File/Print). You may choose the HTML versions (below) or a PDF file of all the charts (26 KB).

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