Hello,

This message was sent from the Health Passport application for your information.

It was sent by: "Name".

If you wish to see the below information in a shorter version, please see here.

If you think you received this message by mistake please contact support.

Thank you,

Health Passport Team

Hospital
Hospital

Your Health Passport will help to let healthcare staff know all about your abilities and needs.

This will help them give you better care when you are in a healthcare setting.

Please ensure that your information is up to date.

To Staff:

Please read this Health Passport and make reasonable adjustments before you undertake any assessment, examination, treatment or care.

Try to make this passport easily available to all staff involved in care.

ALL ABOUT ME

My name is
I like to be called
My birthday is
My birthday is
My telephone number is
I live with
My main carer is
Telephone number of carer
My main keyworker is
Telephone number of keyworker
Parental responsibility
My parent's telephone number is

COMMUNICATION

I communicate by
How best to communicate with me
Support I need to make decisions
My eyesight
My hearing
What I do if I am afraid or worried
How you can support me if I am afraid or worried
Things I do if I am sore or in pain

MEDICAL HISTORY

Things I am allergic to
Other conditions I have
I am on medication
How I prefer to take my medication

LOOKING AFTER ME

How best to gain my help when examining or caring for me
Support I may need with moving
Support I may need with drinking
How to reduce my risk of choking
Support I may need with my oral or dental care
You can help me with my personal care by
Support I may need with using the toilet
Things that help me have a good sleep

KEEPING ME SAFE AND HAPPY

Things that I do or use to keep safe
Things I like
Things I do not like
If my behaviour becomes difficult for you

REVIEW INFORMATION

Completed by
Relationship to Health Passport Owner
Date completed
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