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 Mar 06, 2024.

Fact Checked by Nate Lacson.

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What Is A Personal Health Record Template

While a medical record is the full, comprehensive document comprising a patient’s 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 and medications, and any important contact details, with the goal of the Personal Health Record being a single, go-to reference for a patient’s healthcare information.

For patients with multiple specialist providers, complicated health conditions, the elderly, or those with impairments that prevent them from managing their own medical documentation- our Personal Health Record template can be a game changer.

This Personal Health Record template has been specifically designed to help your patients set out their important medical information in a simple format for easy sharing between providers.

Printable Personal Health Record Templates

Download these Personal Health Record Templates to improve your clinical documentation and HIPAA compliance.

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. To see what sorts of information can be included, just take a look at our Personal Health Record example below. 

Step One. Download the Template

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

Step Two. 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 Three. Assist your Patient to fill 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.

Personal Health Record Example (Sample)

To get a better understanding of how a Personal Health Record template can benefit your patient, just take a look at our example Personal Health Record template below. This example is for a fictional patient who wants to keep track of multiple healthcare providers’ contact details.

Download this Personal Health Record Example (Sample) here: 

Personal Health Record Example (Sample)

Who Can Use this Personal Health Record Template?

This Personal Health Record template is designed to be able to completed by your patient or their representative independently and can be a useful resource for all types of healthcare practitioners. For patients who struggle to recall details of their medical history, this template can be a lifesaver and save both them and their healthcare practitioner much time upon intake. As such, any healthcare professionals who routinely see patients with health conditions, 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, Gynaecologists, etc.
  3. Primary Care Physicians
  4. Registered Dietitians and Registered Dietitian Nutritionists
  5. Therapists, Counselors, and Mental Health Workers
  6. Nurse Practitioners

Why Is This Template Useful For Health Professionals?

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 you to find the information you need.

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.

Keep 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.

EHR feedback

Why Use Carepatron For Personal Health Record Software?

If you’re looking for smart solutions to empower your patients to take better charge of their own health, then look no further than Carepatron- a state-of-the-art practice management software suite.

Carepatron is designed to save you time on administrative and management tasks, so you can get back to helping your patients. Here are just a few things you can do in Carepatron to engage your clients in their health, and reduce your administrative workload so you can help them reach the best possible healthcare outcomes.

  1. Offer your patients access to their own Carepatron patient portal where they can schedule appointments with you and access their medical records securely.
  2. Utilize Carepatron’s comprehensive library of worksheets, note templates, intake forms, and many others to provide your patient with the best possible resources.
  3. Automate SMS or email appointment reminders for your patients to provide a helping hand and reduce your no-show appointments.
  4. Manage your whole team’s calendars from within Carepatron. Carepatron can also handle all your scheduling, billing, and payments, and even conduct secure telehealth consultations.

Finally, you can rest assured that your patient’s medical records are secure in our HIPAA-compliant, bank-level, digitally encrypted data storage, but are also accessible when you need them from Carepatron’s mobile or desktop platforms.

Personal Health Record Software
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 medical 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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