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Below are three sets of
forms in pdf format. Readers of drlowe.com are free to download and/or
print the forms. If you need
assistance in downloading or printing the forms, please phone Tammy
Lowe at (603) 391-6061 or write to her to at Tammy@drlowe.com.
Adobe Reader can be downloaded
and used free.
First
Set. The forms in
the first set are those patients must fill out and submit to the
clinic for the doctor to learn whether they are candidates
for metabolic rehab.
Second
Set. The forms in the second set
are for patient to fill out at intervals during
their metabolic rehab. The purpose in these forms is for the
doctor to evaluate the patient's changing metabolic health status.
Third
Set. The
third set of forms is for patients to use when they're guiding their
own metabolic rehab. The forms are best used in conjunction with
the step-by-step instructions the doctor gives in the book Your
Guide to Metabolic Health.
Fourth Set.
The fourth set of evaluation forms are for those who have taken
charge of their own treatment program. You can, of course, share the
forms with a cooperative health care practitioner, if you have one.
One form is a blank
monitoring sheet, which we call an "individualized monitoring form."
It contains spaces for recording four basal measurements: your
armpit temperature, heart rate, blood pressure, and body weight. The
monitoring form also contains symptom severity scales. You should
label each scale with the name of a predominant symptom that
you want to be free from. Fatigue and hair loss are examples. The first scale is already label "Low
sense of well-being." The second form is an
overstimulation form. It contains 20 of the most common symptoms of
overstimulation. This form is to help you and your clinician detect
and properly deal with early indications of overstimulation.
Instructions for using the form are at
the top of the form. When you evaluate your health status, collect the
appropriate information and fill out both forms. The forms will
provide a running record of your changing status as you progress
through your treatment program.
If you need help in
setting up or guiding yourself through treatment, Dr. Lowe provides
long-distance consulting. To inquire about consulting, please see
our webpage on consulting and
contact Tammy Lowe at
Tammy@drlowe.com. Please
note: Providing these forms does not imply that Dr. Lowe nor those individuals who work under their auspices enter a doctor/patient relationship with any person who
prints or downloads the forms. The forms are provided strictly for
the convenience of readers of drlowe.com. Dr. Lowe and those individuals who work under
their auspices are not
responsible in any way for those who download or print the use the
forms and use them. |