HD Helpful Forms
Index Page


Index Page
HD Helpful Form
Index of Forms
(click on title below)

Download Word Documents          

All articles or Word files that can be down-loaded are located this section. Click on above  for list.  Sections  include:  Appointments, Awareness, At-Home Helpful Forms,  Assessments & Checklists, Estate Planning, Medical, Medications, Outside The Home, and End of Life.

Appointments & Follow Up List-Prepared by Gerri H.-A form to help you keep track of appointments, things discussed and follow up actions which may be necessary.
Walking For HD
Learn how you can help promote HD awareness.  All necessary forms, letters, etc. can be downloaded.
Letter to Doctor-Medications-Prepared by Jean Miller-A sample letter for your primary care physician identifying all of the prescribed medication and OTC products you are taking requesting that they manage those to advise you of any problems or interactions.
Medication & OTC Form                  Prepared by Jean Miller Word document is 2 pages.  This document is to provide  a list of all prescription medications and over the counter  (OTC) products used by an individual.  This should be  attached to the Personal Emergency Information form above.
Prepared by Jean Miller~Word document is 4 pages providing needed data for EMS or other emergency personnel.  This form should be filled out for each member of your family and copies provided to your primary care physician, one in the glove compartment
of each vehicle driven and one posted on the refrigerator  which is where EMS personnel look for information.
Personal Health History               Prepared by Jean Miller-Word document is 5 pages.  This document provides the medical history on an individual.
Picture Cards                                          Prepared by Jean Miller - Samples of communication cards that can be copied or made up to help your loved one with relaying their needs.
A sample letter to provide your physician with a list of up to 5 other symptoms or things you would like them to respond to within a given period of time.
Special Care Instruction booklet-Prepared by Jean Miller-The following pages are from a 12 page Word Document that can be modified to include personal information on a loved one requiring caregiving.  
This provides background on that person to help temporary caregtakers understand your loved one's individual needs and limitations.  When I first made this form it was put together along with pictures of family members, pets, and a "picture-board" of words called "Kelly's Caregiving Handbook".
Things For Caretakers To Remember - A handout to remind temporary caretakers to respect the dignity of your loved one and not to treat them differently because of Huntington's Disease.
Top 3 Things To Discuss With Doctor - A list of the top 3 things or symptoms of critical importance to you that you want to discuss with your doctor on your next appointment or have them respond, in writing, as soon as possible.
A poem and a card to give those "friends" who never visit.