Page 8 - Liver patient passport
P. 8

Information





         Work with your healthcare team to complete the
         information below.

         Having this information to hand when attending all your appointments
         will help your team to understand your management objectives and work
         together to achieve them.

                               dd/mm/yyyy
          My last creatinine
          level was:


          My varices           dd/mm/yyyy
          grade is:


          My dietary
          objectives are:



          My last ascitic      dd/mm/yyyy
          drain was on:


          My last ultrasound   dd/mm/yyyy
          was on:


          Other key measures:


          I have a diagnosis of   Yes                             No
          encephalopathy



          Information presented within this passport does not substitute the advice of a
          healthcare professional.




                           The development of this passport has been sponsored by Norgine.
                      NORGINE and the sail logo are registered trademarks of the Norgine group of companies.
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