Care Team

# Shared Care Plan Your Personal Health Record

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Name Birth Date, Age, Gender

Home | Care Team | About Me | Diagnoses | Next Steps | Health Log | Medications | Reactions | History | Adv. Directives

# Emergency Contact (HELP) Your Emergency Contact is the person you would like called first should you have an emergency. Your Backup Emergency Contact is the person you would like called if your primary Emergency Contact is unavailable. Edit Emergency Contact

# Emergency Contact: Name: Phone Number: Alternate Phone Number:

# Backup Emergency Contact: Name: Phone Number: Alternate Phone Number

# Care Team Members (HELP) Care Team Members are people and/or organizations who help you manage your health. Anyone who you feel has a role in your health. SORT ADD NEW

Appts. Name Contact Role/Description Access Level Comments Action (Edit)

> # Keys to Symbols Lock | Indicates that the patient has marked an item as private (hidden from one or more Care Team members). Your respect of this sensitive information is appreciated. i | Place your mouse cursor over an information icon (don't click) to see who last updated the item and when. Orange Triangle | These information icons indicate items updated since you last viewed this Shared Care Plan. Orange * | Indicates a required field