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Care records
The One Place Caregiver Binder
Keep one person’s medicines, appointments, daily care notes and care team in one place, so a backup helper can step in.
- Fillable PDF
- US Letter
- 24 pages
- Instant download
Instant download · One-time payment
Look inside
The top of four pages, shown with sample entries for an invented household. The file you download comes blank, ready for your own entries.
What is inside
- Start page (how to use, where the binder is kept, who was told) with a contents page-number list
- Care at a glance: one page a backup helper can start from
- Care team and helpers: 4 contact records over 2 pages
- Medication list: 6 medicine records over 3 pages, with a name field wide enough for long medicine names
- Medication changes record: 2 entries, each linked to the list and the weekly chart
- Weekly medication chart: 4 weeks, 2 pages a week, 6 medicines a week, 3 typed time rows per medicine, Monday to Sunday tick boxes
- Appointment pages: 2 pages that run from questions to ask, to visit notes, to follow-up actions
- Daily care log: 4 pages, each ending with a note for the next helper
- Insurance and pharmacy page: 2 coverage records and 1 pharmacy record
- Care notes and review page
What it is for
Keep one person's medicines, appointments, daily care notes and care-team contacts in one place, so a backup helper can step in.
What you need
A PDF app that fills forms (typing tested in pdf.js, the engine of Firefox's PDF viewer), or a printer and a pen. US Letter paper.
Making it yours
Type or write the person's name and every entry yourself; the pages come blank. No business name or logo.
Delivery
Instant download after checkout: one fillable PDF, US Letter.
Specs
| Pages | 24 |
|---|---|
| Paper sizes | US Letter |
| File | One fillable PDF |
| Fillable fields | 839 (text, multi-line and tick boxes) |
| Weekly chart | 4 weeks, 6 medicines a week |
| Navigation | Contents page and a bookmark for every page |
Before you buy
- Not legal advice. Not a will.
- US Letter only; on A4 paper print with Fit to page.
- Typing tested only with pdf.js (Firefox's PDF engine); other apps not tested.
- No medical advice: you copy instructions from the prescriber or pharmacy label. The binder gives no doses, schedules or missed-dose guidance.
- Records one person's care. It is not a clinical tracker: there are no vital-sign, symptom or pain charts.
- The weekly chart holds 6 medicines a week with 3 typed time rows each, for 4 weeks. For more, print a spare blank page.
- Asks for no passwords and no full policy, member or account numbers.
- Long entries may shrink or wrap depending on your PDF app; we tested typed sample entries in pdf.js only.
- The file is blank: it includes no filled example pages and no editable Word or Canva version.
- Typed entries use the viewer's standard Latin font: some accented letters (for example ś) may not display when typed; write those by hand.
Questions about this file
Does it tell me doses or schedules?
No medical advice: you copy instructions from the prescriber or pharmacy label. The binder gives no doses, schedules or missed-dose guidance.
How many medicines fit?
The weekly chart holds 6 medicines a week with 3 typed time rows each, for 4 weeks. For more, print a spare blank page.
Does it track symptoms or vital signs?
No. It records one person’s care. It is not a clinical tracker: there are no vital-sign, symptom or pain charts.
Does it come with filled examples?
No. The file is blank: it includes no filled example pages and no editable Word or Canva version.
Goes well with
All products
Care records