Use this record 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.
Checkup/Test | Date/Results | |||||
Blood Pressure | ||||||
Blood Sugar | ||||||
Bone Density | ||||||
Cholesterol | ||||||
Dental Visits | ||||||
Hearing | ||||||
Tuberculosis | ||||||
Vision | ||||||
Weight |
Return to Prevention Charts
Pocket Guide to Good Health for Adults