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1 S Syndrome Association1 DWLRQDO 2I FH /DQJGRQ 'RZQ &HQWUH D /DQJGRQ 3 DUN 7 HGGLQJWRQ 0 LGGOHVH[ 7: 367HO )D[ ( PDLO LQIR#GRZQV V\QGURPH RUJ XN:DOHV 'RZQ V 6\QGURPH $VVRFLDWLRQ 6 XLWH :KLWFKXUFK 5 RDG +HDWK &DUGLII &) 1% 7HO )D[ 1 RUWKHUQ ,UHODQG 8 QLW 0 DUOERURXJK +RXVH /LVEXUQ 5 RDG %HOIDVW %7 *+ 7HO )D[ down s Syndrome Association3 XEOLFDWLRQ GDWH 7 KDQN \RX WR $QG 7RP %DFKRIQHU IRU WKHLU VXSSRUW RI WKLV s Syndrome Association1 DWLRQDO 2I FH /DQJGRQ 'RZQ &HQWUH D /DQJGRQ 3 DUN 7 HGGLQJWRQ 0 LGGOHVH[ 7: 367HO )D[ ( PDLO LQIR#GRZQV V\QGURPH RUJ XN:DOHV 'RZQ V 6\QGURPH $VVRFLDWLRQ 6 XLWH :KLWFKXUFK 5 RDG +HDWK &DUGLII &) 1% 7HO )D[ 1 RUWKHUQ ,UHODQG 8 QLW 0 DUOERURXJK +RXVH /LVEXUQ 5 RDG %HOIDVW %7 *+ 7HO )D[ down s Syndrome Association3 XEOLFDWLRQ GDWH 7 KDQN \RX WR $QG 7RP %DFKRIQHU IRU WKHLU VXSSRUW RI WKLV SURMHFW /LHS[O )VVR /LHS[O )VVR145399 covers 121/01/2014 14:58 Trim x mm My Health Checks145399 Downs Hlth Chk 122/01/2014 11.]]]]]]]]]]

2 29 About this health bookEach page of this health book is available as a download from DSA s website when replacement pages are of the Health BookO This health book will help you and your GP to look after your healthO 7 KHUH LV D SDUW RI WKLV ERRN IRU \RX WR OO LQ DQG SDUW RI WKH ERRN IRU \RXU *3 WR OO LQ O You can ask someone for help to make sure all the right information goes into the bookO Remember to take this health book with you when you go to see your GPO You should have a health check at least once every yearO If your GP does not offer annual health checks, ask him/her to tell you the name of a local GP who doesO You can get information about adult annual health checks from the DSAO It is important for us to hear what you think about the health book. You can tell us what you think about the health book by email: This health book is a tool to guide you through the health conditions that are more typically seen in people with down s syndromeO It may be used during an annual adult health check or a general appointmentO It is not a step by step guide to carrying out an adult health check as that information already exists in other formatsO 7 KHUH LV D VHFWLRQ IRU \RX WR OO LQ WRZDUGV WKH HQG RI WKH ERRNO :H KDYH VHW XS D ZHEVLWH IRU *3V WR EH XVHG LQ FRQMXQFWLRQ ZLWK WKLV KHDOWK ERRN ZLWK 'RZQ V V\QGURPH VSHFL F health information at We would very much like to hear what you think of the health book and GP website.

3 Please send your feedback to: Downs Hlth Chk 222/01/2014 11:29 Name:Date of Birth:NHS Number:Address:All About MeMy ContactsEmergency Contact: Name: Address:Telephone: Mobile:Family, friends and carers who help me with my health:Name: Address: Telephone: Mobile:Name: Address: Telephone: Mobile:Name: Address: Telephone: Mobile:My next of kin is: Name: Address: Telephone: Mobile: your photo145399 Downs Hlth Chk 322/01/2014 11:29GP:Name: Address:Telephone: Other Health Professionals who help me with my health:Name: Role: Address: Telephone:Name: Role: Address: Telephone:Name: Role: Address: Telephone:My Contacts145399 Downs Hlth Chk 422/01/2014 11:29I have these allergies:I have these phobias / I am afraid of these things: ( needles, plasters)I take these medicines every day:I sometimes take these medicines:Before we start important things that you need to know about me145399 Downs Hlth Chk 522/01/2014 11:29To Communicate I use: (Tick the boxes that apply)My voice Pictures SignsCommentsConsentThese are the people you can talk to about my health: ( parents/carers, support workers)These are the people who I DO NOT want you to talk to about my health: ( parents/carers, friends, support workers)Other things you need to know including family health conditions:I do understand what you say I don t understand what you say145399 Downs Hlth Chk 622/01/2014 11:29 2014 Tick if you need help with any of these a little bit about this.

4 2015 Tick if you need help with any of these thingsWrite a little bit about if you need help with any of these a little bit about this. Washing DressingGoing to the toiletEatingDrinkingThis is about things I need help with145399 Downs Hlth Chk 722/01/2014 11:292014 Tick if you need help with any of these a little bit about this. 2015 Tick if you need help with any of these thingsWrite a little bit about if you need help with any of these a little bit about this. TravellingWalkingWritingReadingTaking MedicineThis is about things I need help with145399 Downs Hlth Chk 822/01/2014 11:29 Name of hospitalDate of visit Reason for my visit to hospital Who I saw at the hospital/name of doctor/consultant What happened at the hospital/outcomesThis is about my visits to the Hospital145399 Downs Hlth Chk 922/01/2014 11:29,Q VLJQLQJ WKLV GRFXPHQW , DJUHH WKDW WKH LQIRUPDWLRQ LQ WKLV OHD HW PD\ EH VKDUHG ZLWK KHDOWK DQG FDUH ZRUNHUVMy Weight isMy Body MassIndex (BMI)My Height isI smoke yes/noI drink this much alcoholThis is the exercise that I doI have had these vaccinations / injectionsDate CompletedBy WhomRelationship to patientThis is about my health2014 2015 2016145399 Downs Hlth Chk 1022/01/2014 11.

5 29)RU \RX WR OO LQ )RU WKH *3 WR OO LQ These are my health issuesEarsEyesSkin / NailsHeartTests undertaken & commentsWrite more about this health problem hereTick Checked Yes/NoBlood PressureCholesterolBones / Muscles / JointsGP information available at Downs Hlth Chk 1122/01/2014 11:29 These are my health issuesTeethNeck InstabilitySleepBreathingSeizuresCoeliac DiseaseGoing to the toiletTests undertaken & commentsWrite more about this health problem hereTick Checked Yes/NoPeriods)RU \RX WR OO LQ GP information available at )RU WKH *3 WR OO LQ 145399 Downs Hlth Chk 1222/01/2014 11:29 These are my health issuesContraceptionDiabetesThyroidDepres sionWorryVitamin B12 'H FLHQF\)RU \RX WR OO LQ )RU WKH *3 WR OO LQ Tests undertaken & commentsWrite more about this health problem hereTick Checked Yes/NoGP information available at Downs Hlth Chk 1322/01/2014 11:29If these issues are arising in conjunction with skill loss, weight loss, withdrawal go to: are my health issuesProblem with swallowing)RU \RX WR OO LQ )RU WKH *3 WR OO LQ Tests undertaken & commentsWrite more about this health problem hereTick Checked Yes/NoMemory - Forgetting thingsGait - walking about - MovingGP information available at Downs Hlth Chk 1422/01/2014 11:29 Other health issues:Further information:145399 Downs Hlth Chk 1522/01/2014 11:29 Date in 2015:Date in 2016:Date in 2017.

6 My next annual appointment is on:Completed by:Name of GP: Address of surgery: Date: Signature: 2014 2015 2016145399 Downs Hlth Chk 1622/01/2014 11 s Syndrome Association1 DWLRQDO 2I FH /DQJGRQ 'RZQ &HQWUH D /DQJGRQ 3 DUN 7 HGGLQJWRQ 0 LGGOHVH[ 7: 367HO )D[ ( PDLO LQIR#GRZQV V\QGURPH RUJ XN:DOHV 'RZQ V 6\QGURPH $VVRFLDWLRQ 6 XLWH :KLWFKXUFK 5 RDG +HDWK &DUGLII &) 1% 7HO )D[ 1 RUWKHUQ ,UHODQG 8 QLW 0 DUOERURXJK +RXVH /LVEXUQ 5 RDG %HOIDVW %7 *+ 7HO )D[ down s Syndrome Association3 XEOLFDWLRQ GDWH 7 KDQN \RX WR $QG 7RP %DFKRIQHU IRU WKHLU VXSSRUW RI WKLV s Syndrome Association1 DWLRQDO 2I FH /DQJGRQ 'RZQ &HQWUH D /DQJGRQ 3 DUN 7 HGGLQJWRQ 0 LGGOHVH[ 7: 367HO )D[ ( PDLO LQIR#GRZQV V\QGURPH RUJ XN:DOHV 'RZQ V 6\QGURPH $VVRFLDWLRQ 6 XLWH :KLWFKXUFK 5 RDG +HDWK &DUGLII &) 1% 7HO )D[ 1 RUWKHUQ ,UHODQG 8 QLW 0 DUOERURXJK +RXVH /LVEXUQ 5 RDG %HOIDVW %7 *+ 7HO )D[ down s Syndrome Association3 XEOLFDWLRQ GDWH 7 KDQN \RX WR $QG 7RP %DFKRIQHU IRU WKHLU VXSSRUW RI WKLV SURMHFW /LHS[O )VVR /LHS[O )VVR145399 covers 121/01/2014 14:58]]]]]]]]]]