Caregiver Journal
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CAREGIVER JOURNAL
Caregiver Journal
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Week 1
Medicines given
Questions to ask before week 2
Call your doctor right away if you have a side effect that bothers you, that doesn’t go away, or for medical advice. You may also report side effects to United Therapeutics Corporation at [email protected] or by contacting FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
Notes/Observations at home
Notes/Observations in hospital
Caregiver Journal
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Week 2
Medicines given
Caregiver Journal
Questions to ask before week 3
Notes/Observations at home
Notes/Observations in hospital
Call your doctor right away if you have a side effect that bothers you, that doesn’t go away, or for medical advice. You may also report side effects to United Therapeutics Corporation at [email protected] or by contacting FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
Caregiver Journal
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Week 3
Medicines given
Caregiver Journal
Questions to ask before week 4
Notes/Observations at home
Notes/Observations in hospital
Call your doctor right away if you have a side effect that bothers you, that doesn’t go away, or for medical advice. You may also report side effects to United Therapeutics Corporation at [email protected] or by contacting FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
Caregiver Journal
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Week 4
Medicines given
Caregiver Journal
Questions to ask before week 5
Notes/Observations at home
Notes/Observations in hospital
Call your doctor right away if you have a side effect that bothers you, that doesn’t go away, or for medical advice. You may also report side effects to United Therapeutics Corporation at [email protected] or by contacting FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
Caregiver Journal
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Week 5
Medicines given
Caregiver Journal
Questions to ask before week 6
Notes/Observations at home
Notes/Observations in hospital
Call your doctor right away if you have a side effect that bothers you, that doesn’t go away, or for medical advice. You may also report side effects to United Therapeutics Corporation at [email protected] or by contacting FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
Caregiver Journal
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Week 6
Medicines given
Caregiver Journal
Questions to ask
Notes/Observations at home
Notes/Observations in hospital
Call your doctor right away if you have a side effect that bothers you, that doesn’t go away, or for medical advice. You may also report side effects to United Therapeutics Corporation at [email protected] or by contacting FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
Caregiver Journal
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Doctor (Name)
Phone
Nurse (Name)
Phone
Hospital Name
Phone
Pharmacy Name
Phone
Use this space to keep track of the contact information for your child’s healthcare team.
Caregiver Journal
Caregiver Journal
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Caregiver Journal
Notes
© 2017 United Therapeutics Corporation. All rights reserved. US/DS/0071 Printed in USA.