Disability Care Plan
Written by: [Your Name]
Date: [Date]
I. Client Information
Client Name | [Client's Name] |
Date of Birth | [Date of Birth] |
Email | [Client's Email] |
Contact Information | [Client's Contact Number] |
Address | [Client's Address] |
Emergency Contact | [Client's Contact Person] |
II. Medical History
Diagnosis: Type 2 Diabetes
Date of Diagnosis: [Date]
Primary Physician: [Your Name]
Medication: Metformin, Dosage: 500mg, Frequency: Twice daily
Specialists Involved:
Endocrinologist - Dr. Michael Patel, Nutritionist - Karen Wong
III. Support Needs
IV. Goals
Short-term Goals | Maintain blood sugar levels within the target range, Attend all scheduled appointments |
Medium-term Goals | Lose 10 pounds through dietary changes and exercise, Learn carbohydrate counting |
Long-term Goals | Achieve HbA1c below 7%, Establish a sustainable lifestyle to manage diabetes effectively |
V. Care Plan
Breakfast | Metformin |
Lunch | Balanced meal with low glycemic index |
Dinner | Metformin |
Evening | Light exercise or walk |
VI. Additional Notes
Plan Templates @ Template.net
