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# Shared Care Plan Your Personal Health Record

>SIGNED IN: Jasper Wardin My Registration Sign Out

NAME Date of Birth, Age, Gender

> * Printout Options * Privacy Summary * Who's accessed my Plan?

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

# Allergies / Intolerances (HELP) These are substances (Drug, food, or otherwise) that cause a bad reaction when you take, inhale or in some way come in contact with them. Add New

i | Substance | Date Occurred | Type | Documented By | Reaction| Action

# Contraindications (HELP) These are substances (such as drugs and food) that interact badly with your condition or medications that you are already taking. Add New Substance | Reason | Documented By | Action Edit I have no known contraindications. (Click the [Add New] button to add a new contraindication.)

> # 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