Juggling Cystic Fibrosis

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This journal contains the following information: • Personal Information Pages: Name, DOB, SS#, phone, fax, emergency numbers, clinic#, doctor #, and pharmacy #, genotype, blood type, information concerning diagnosis, allergies. • Insurance Information: Private, Medicaid, SSI, and CIDC insurance information. • Doctor Phone List: Detailed, Pharmacy Information: Medical supply companies, and alternates, Clinic Staff Sheet • Immunization Record, Baseline Information, CPT schedule, Suggested Diet, Current Medication Lists, and Tentative Changes to Current Medication List • School Information: Medications that the school has and information pertaining to those medications, School Absence Information • Appointment Schedules • Clinic Visit Pages: This section allows for 20 clinic visits to be recorded. Each visit is condensed into 4 pages of information, as follows: Height, weight, overall health, medication changes, CPT changes, tests performed, results, next appointment date, what to bring, what to expect, notes, doctors seen at this visit, new prescriptions needed, a question and answer section is included. • Height and Weight Record, Culture Information • Drug History: Complete listing of drugs taken and tried, as well as reactions. Antibiotic History: Complete listing of antibiotics taken, and tried as well as reactions. • Enzyme History, Vitamin History, Pulmonary Function History, Pulse Oximetry Tests, Chest Radiographs • Past Medical History, Surgical and Hospitalization History • Equipment Information, Supply Information • Illness Records: Symptoms, temperature, respitory rate, drugs given • Problem Plan Sheets: Problem that may occur, medication and planning for problem • Doctor Phone List, Resource Phone List, Online Resources, Family and Friends Phone List, Contact Log, Notes section

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