Personal Care Records are a way for caregivers and facilities to record and track events, meals, vitals, and to keep notes about routine checks so a patient’s overall well-being and progress can be monitored on a consistent basis.
Information generally recorded on this form includes patient name, bed number, diagnosis, vitals (heart rate/pulse, temperature, respiration, blood pressure, weight, etc.), caregiver name, diet/food input, bowel movements, personal care diary (oral events, cleansing/bath record, skin care notes, etc.), and other tracked metrics so results can be measured for improvement or decline over time.
This form is highly customizable (although some stock variations are available) so that you can organize and record all data points in a manner consistent with the workflow and operations of your facility. There are no limits to what we can preprint on this form for you so whether you’re looking to replicate a form you’re currently using, add your branding/make modifications to an existing form, or design something completely from scratch our customer service and state of the art graphics team are committed to providing you the best possible form to improve quality of care.
- Freight additional using most economical carrier
- 1,500 forms per case
- Production time estimated at 10 days on repeat orders
- PAS manufactures Personal Care Forms/Records/Charts for nurses, caregivers, facilities, hospices, and other medical professionals to track resident’s health on an ongoing basis.
- The goal of this form is to document observations, incidents, comments, and other treatment events with the goal of improving patient care.
- 8.5" x 11" size
- Price per 1,000
- Packaged 1,500 per carton
- Portrait or Landscape Orientation Available
- Compatible with all major laser printers
- Printing available in up to 6 total colors
- White 28 leger paper but other weights available (price will vary)
- 5 and 10 hole punch available to fit common facility charts/binders
- Pricing includes standard 5 hole punch
- For 10 Hole Punch add $85 flat fee per order
- Unlimited potential for customization to suit the unique needs of facilities or pharmacies providing the record
- Differentiate yourself from your competition (most of whom use stock forms) by adding your branding and unique color scheme
- If you’re looking to copy an existing design you can submit a scan or image of your current form here.
- 8.5" x 11" Laser Cut Sheet
- 1,500 per case
- Priced per 1,000
- Up to 6 colors total
- Pricing includes 5 hole punch