Personal Health Record Template

Help your patients take charge of their health and maintain a Personal Health Record using our PDF Personal Health Record template with a medication table, vaccination history, emergency contacts, and personal information section.

By Telita Montales on Jul 17, 2024.


Fact Checked by Nate Lacson.

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Personal Health Record Template PDF Example
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What is a Personal Health Record Template?

You are not always at your patient’s side whenever they need their health record or documentation. Thus, having a Personal Health Record within their reach can be particularly practical, especially for patients with multiple specialist providers, complicated health conditions, the aging population, or those with impairments that prevent them from managing their medical documentation.

While a medical record is the full, comprehensive document comprising a patient’s personal health information, past medical treatments, progress notes, test results, and all their other medical encounters, a Personal Health Record, or PHR, is a tool for a patient to manage their own medical documentation, and record details relating to their past medical care. This may include their current medical conditions, medications, any important contact details, and emergency contacts to ensure this information is accessible in case of emergency situations. The goal of the Personal Health Record is to be a single, go-to reference for a patient’s healthcare information.

Electronic health records are similar to a PHR, but they are more extensive and comprehensive because EHRs are managed and controlled by doctors, clinics, or healthcare facilities.

A Personal Health Record Template can help your patients record their important medical information in a simple format that is easy to share between healthcare industry providers.

How to use this free Personal Health Record Template 

It's simple to get started using this Personal Health Record Template, just follow this step-by-step guide to help your patients create their own Personal Health Records.

Step 1: Download the template

The first step is to download the Personal Health Record Template. You can download the free PDF version using the link on this page or alternatively access this template and many others from within Carepatron. 

Step 2: Provide it to your patient

The next step is to provide a copy of this template to your patient or their guardian/representative, this may be either digital or you can print it out and provide them with a paper copy. For elderly patients or those with impairments that prevent them from being able to manage their own health information, you should provide the template to the patient's caregiver or legal representative. 

Step 3: Assist your patient in filling out the template

If they need, offer to fill in any parts of the Personal Health Record that relate to you- e.g. your name and designation as their healthcare practitioner. For some patients, you can simply provide them with the template and perhaps highlight a few of the different sections that would apply to them.

Who can use this Personal Health Record Template?

This printable Personal Health Record Template is designed to be able to be completed by your patient or their representative independently and can be a useful resource for all types of health care providers and medical professionals. It can also be used in medical practice settings to help patients manage their health information.

As such, any healthcare professionals who routinely see patients with health concerns, specialist physicians, or a more complicated medication regime can benefit from offering this template to their patients. Here are just a few:

  1. Geriatricians or aged care workers
  2. Specialists such as endocrinologists, cardiologists, gynecologists, etc.
  3. Primary care physicians
  4. Registered dietitians and registered dietitian nutritionists
  5. Therapists, counselors, and mental health workers
  6. Nurse practitioners

For patients who struggle to recall medical details, this template can be a lifesaver and save them and their healthcare practitioners much time upon intake.

Why is this template useful for health professionals?

We want to assist you in making things convenient and accessible to your patients and using this template will definitely be a handy tool in your healthcare toolkit. Here's why:

It is clearly formatted

Digging through a patient's medical record for a key piece of information can be a daunting task, but luckily with our Personal Health Record Template, your patient will have already laid out their key healthcare information in a single, pre-formatted document; making it easy for to find the information needed.

It contains space for additional notes

We have also included space for any additional information your patient may wish to include in their Personal Health Record, so nothing important gets left out.

It keeps it up-to-date

Some years may be more eventful than others in terms of updates to a Personal Health Record- and we have taken this into account with a dedicated space to add the date the template was last updated. This gives healthcare practitioners a clearer picture of how recent the information contained within this template is.

What’s the difference between a Personal Health Record and an Electronic Health Record?
What’s the difference between a Personal Health Record and an Electronic Health Record?

Commonly asked questions

What’s the difference between a Personal Health Record and an Electronic Health Record?

An Electronic Health Record (EHR) comprises all the documentation related to a patient’s health history stored by a particular provider. The EHR is generally maintained by the provider for reference, legal and billing purposes. The Personal Health Record (PHR), conversely, is a record maintained by the patient themselves for their personal reference. A PHR will not necessarily be as comprehensive as the EHR and may prioritize certain types of information depending on the patient’s needs.

Who can use Personal Health Record templates?

Any patients who want to get all their key medical information into a single easy-to-read document can benefit from using this Personal Health Record template. Patients that may find this template particularly useful are those who usually struggle to recall details of their medical history, who see multiple specialists, or who are seeing a new practitioner for the first time and need to convey key medical information to a new provider.

Do I need to fill this out for my patients?

Not necessarily. Your patient may have some of their medical information available, but be unsure on certain points and need assistance from you on some details. For emergency contact details, and the personal information section- you should leave this to your patient or their representative to fill out.

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