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An interactive workbook to help you take control of your own health and wellness

ver. 14 Š 2014 Accent Wellness Binder. All Rights Reserved.

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Current Health Information & Medical Card ID Appointment Records, Health History and Prescriptions Lab Work, Test Results and Vaccinations

Doctors Notes and Specialists

Wellness Strategy and Preventive Care

Nutrition, Diet and Exercise

Dental, Vision, Chiropractic Care and Holistic Health The Human Body and Education

Emotional and Financial Wellness Insurance and EOB’s (Explanation of Benefits) and Extra Forms to Copy ver. 14 Š 2014 Accent Wellness Binder. All Rights Reserved.

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Introduction When you live in a state of “wellness” you don’t need to be sick. The best way to stay well is to live a lifetstyle that includes good food, exercise, sleep, and purpose. The circumstances that bring you into the world are beyond your control, but once you are here, you can make decisions that increase your chance of living a long and healthy life. Your first 20 years set the groundwork for your entire life. Every stage of living offers an opportunity to make choices that will affect you long term. With a little participation and attention, you can increase your chances of a favorable outcome.

The lab forms, medication diaries, appointment logs and medical trackers in this binder may be duplicated and shared. Please make as many copies as you need. “Whatever you pay attention to improves.”

The truth is that the circle of life includes death. It is a normal and expected outcome of life. However, there are many things within your control that can influence the inevitable. This Wellness Binder is intended to help you take control of your healthcare, so that you may make better decisions about your future and your present. In the end, you are responsible for yourself. It pays to be empowered with information and data to help you make more informed decisions. This Wellness Binder can also help share information with those in charge so that as you age, others are more empowered to help you with care.

ver. 14 © 2014 Accent Wellness Binder. All Rights Reserved.

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Childbirth welcomes you into the world for a future that is yet to be determined.

Get educated, learn a skill, apply yourself. Make good choices. Eat well. Exercise. Have fun. Work hard & raise a family. Be financially responsible. Manage money. Take family vacations. Stay married. Eat well. Exercise. Get checkups. Join Medicare.

Tennis, golf, travel, grand kids, reading, & all the fun things you always wanted to do! Draw Social Security. Extra time to enjoy life. Your eyes, spine & healthy brain keep life fun. Bonus years to enjoy the fruits of your labor.

Find a job & a mate! Learn about finances. Create some hobbies & make friends. Travel & make memories! Watch your waist! Protect your heart. Keep moving your body!

Preventive maintenance and early detection are key. Keep moving and using your brain. Retirement or reinspired? What makes you happy? What else do you want to learn? Quality of Life vs Quantity of Life.

Did you ever think you would live so long?

Estate planning & philanthropy are a beautiful thing! Family values can be a gift that keeps on giving.

ver. 14 Š 2014 Accent Wellness Binder. All Rights Reserved.

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Current Health Information & Medical Card ID

ver. 14 Š 2014 Accent Wellness Binder. All Rights Reserved.

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Identify Your Risk Factors Maintaining wellness means understanding and identifying potential risk factors for your health. A risk factor increases the likelihood that a certain illness or disease will occur or happen to you. Uncontrollable risk factors include: • Genes and your family history for a particular disease. • Gender. • Ancestry. • Age. • Health history — some medical conditions increase the likelihood of developing other related diseases. Risk factors that can be controlled include:

How does your DNA affect the body you have? Well... How well did you pick your parents? What family history are you aware of? So where are you now? Take a moment to look at it.

• Diet and nutrition. • Physical activity and exercise. • Alcohol intake. • Drug use. • Wearing seatbelts.

If you have a family health history, talk to your doctor so that your doctor can assess your risk and recommend things to do to help prevent disease and encourage wellness.

ver. 14 © 2014 Accent Wellness Binder. All Rights Reserved.

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Medical History Summary Name: _______________________________________________ Date of Birth: ____________________ Age: __________ Where were you born? __________________________________________________________ Do you have any brothers and sisters? q Yes q No Which birth order are you? ____________________ Are your parents alive? q Yes q No Age at death and cause of death if known: _______________________________________ _________________________________________________________________________________ Family history issues: ___________________________________________________________ What is your relationship status? q Single q Married q Divorced q Widowed Partner name and age:__________________________________________________________ What is the state of your present health? ________________________________________ Your height: ____________ Your weight: ____________ Blood Pressure:_____________ Have you had any surgeries in the past? q Yes q No __________________________ Do you know your blood type? q Yes: __________ q No Are you taking any medications? q Yes q No If yes, which medications and for what conditions? _____________________________ Lifestyle Are you working? q Yes q No Occupation: ____________________________________ Do you have hobbies? q Yes q No _____________________________________________ What do you like to drink socially? ______________________________________________ Do you enjoy walking, exercise or working out? q Yes q No What are your health goals? _____________________________________________________ _________________________________________________________________________________

ver. 14 Š 2014 Accent Wellness Binder. All Rights Reserved.

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Diagram Known Health Issues | Male Use this diagram to help identify known health issues.

ver. 14 Š 2014 Accent Wellness Binder. All Rights Reserved.

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Diagram Known Health Issues | Female Use this diagram to help identify known health issues.

ver. 14 Š 2014 Accent Wellness Binder. All Rights Reserved.

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Medical Event History: What Happened When? Date

Medical Event

Details

ver. 14 Š 2014 Accent Wellness Binder. All Rights Reserved.

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Medication and Supplement Tracker Knowing which prescriptions you take, the amount you take and frequency, as well as why you are taking it is important information. Drug management can be challenging and being accountable to medications and their results and reactions are an important part of your health.

Which pharmacy do you like to use?

Contact information:

Medication or Supplement: ________________________ Brand: ________________ Generic:_______________________ What is it for? ________________________________________ Dosage: ______________________________________________ Doctor who prescribed it: _____________________________ Start/Stop Date: ______________________________________ AM or PM medication (circle one) Refill #: ______________________________________________ Pharmacy that filled it? _______________________________ Remaining # of Refills: _______________________________ If I miss my dose, I should : ___________________________

ver. 14 Š 2014 Accent Wellness Binder. All Rights Reserved.

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Medication and Supplement Tracker Medication or Supplement: ________________________ Brand: ________________ Generic:_______________________

Which pharmacy do you like to use?

What is it for? ________________________________________ Dosage: ______________________________________________ Doctor who prescribed it: _____________________________

Contact information:

Start/Stop Date: ______________________________________ AM or PM medication (circle one) Refill #: ______________________________________________ Pharmacy that filled it? _______________________________ Remaining # of Refills: _______________________________ If I miss my dose, I should : ___________________________

Medication or Supplement: ________________________ Brand: ________________ Generic:_______________________ What is it for? ________________________________________ Dosage: ______________________________________________ Doctor who prescribed it: _____________________________ Start/Stop Date: ______________________________________ AM or PM medication (circle one) Refill #: ______________________________________________ Pharmacy that filled it? _______________________________ Remaining # of Refills: _______________________________ If I miss my dose, I should : ___________________________ ver. 14 Š 2014 Accent Wellness Binder. All Rights Reserved.

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Weekly Medication Diary DID you know a weekly medication diary can promote better health? Being accountable to another person, or medication tracker like this one, increases your likelihood of consistently taking your medication. The most effective medicines are those that are taken consistently and according to the doctor’s instruction. Start tracking! Medication Name

Mon

Example Medication

AM PM

Tue

Wed

Thu

Fri

Sat

Sun

ver. 14 Š 2014 Accent Wellness Binder. All Rights Reserved.

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