My Care Diary
RESOURCES
• To schedule or reschedule my appointments, I should call:___________________________________________________
____________________________________________________________________________________________________________
• I should bring to my appointments:_________________________________________________________________________
____________________________________________________________________________________________________________
List Of Future Appointments
Date:_______________________________________________________________________________________________________
Time:_______________________________________________________________________________________________________
Location:___________________________________________________________________________________________________
Provider:____________________________________________________________________________________________________
Purpose:____________________________________________________________________________________________________
____________________________________________________________________________________________________________
Supplies Or Equipment Needed
• I will need:_________________________________________________________________________________________________
____________________________________________________________________________________________________________
• If I need more supplies, I should call:________________________________________________________________________
____________________________________________________________________________________________________________
26 Patient & Visitor Guide