My Health Passport(for patients with diabetes/hypertension)

Name：

Published�by�Department�of�HealthPrinted�by�Government�Logistics�Department

August�2017

1

My Health Passport

The aim of this passport is to help you record down the information of your family doctor or dentist and to learn more about the effect of treatment so as to modify the management plan if needed. The passport can be used for about two years, depending on the frequency of your follow-up appointments.

Please remember to bring along your health passport forevery follow-up appointment. This will help your family doctor or dentist, and other healthcare professionals understand your health conditions and facilitate discussion of your management plan.

Content Page

1. Information of My Family Doctor 22. Information of My Family Dentist 3 3. My Personal Health Information 44. My Follow-up Appointments (Family Doctor) 55. My Follow-up Appointments (Family Dentist) 76. Examination Record and Treatment Outcome

(Regular Follow-up Appointments) 87. Examination Record and Treatment Outcome

(Annual Assessment) 328. Blood Pressure Record 409. Blood Glucose Record 4310. Health Commitment 4711. Resource Corner 49

1. Information of My Family Doctor (To be filled by your family doctor)

My family doctor: (Name)

Please affix the name card of your family doctor

My family doctor has joined the following primary care schemes:

Health Care Voucher Yes / No

Vaccination Subsidy Scheme Yes / No

2. Information of My Family Dentist(To be filled by your family dentist)

My family dentist: (Name)

Please affix the name card of your family dentist

My family dentist has joined the following primary care scheme:

Health Care Voucher Yes / No

32

54

3. My Personal Health Information(To be filled by oneself)

Date of birth:

Sex:

Address:

Telephone:

Medical history:

Drug allergy:

Food allergy:

Long-term medication(s):

Registration number of eHR Sharing System:

Emergency contact

In case of emergency, please contact the following persons:

Name Relationship Telephone number

4. My Follow-up Appointments (Family Doctor) (To be filled by oneself)

Follow-upAppointment

Date Time Remarks

st1

nd2

rd3

th4

th5

th6

76

4. My Follow-up Appointments (Family Doctor) (To be filled by oneself)

Follow-upAppointment

Date Time Remarks

th7

th8

th9

th10

th11

th12

5. My Follow-up Appointments (Family Dentist)(To be filled by oneself)

Follow-upAppointment

Date Time Remarks

st1

nd2

rd3

th4

th5

th6

98

6. Examination Record and Treatment Outcome(Regular Follow-up Appointments)

- To be filled by your family doctor or dentist after each regular follow-up appointment.

- Part A is applicable for patients with hypertension or diabetes. Part B is applicable for patients with diabetes only.

Date of follow-up appointment

Examination Item Treatment Target ExaminationRecord

Treatment Outcome Please give a score by

circling a star(5 stars means highest scores)

Remarks

(Part A) Patients with hypertension or diabetes

Blood pressure

Lower than 140/90mmHg for patients with hypertension

Lower than 130/80mmHgfor patients with diabetes

Life

styl

e

Diet control Follow recommendations given by doctors or other healthcareprofessionals such as dietitian

Yes / No

Regular exercise Yes / No

Smoking habit No smoking Yes / No

Oral hygiene

practice(Note) Establish proper tooth cleaning habit

Maintain teeth and gum healthyYes / No

Medication(s) Comply with doctors’ advice Yes / No

Others

(Part B) Patients with diabetes

Blo

odgl

ucos

ele

vel Fasting Blood glucose level being 4-7 mmol/L

1 or 2 hoursafter meal Blood glucose level below 10 mmol/L

Oral examination (Note) No accumulation of plaque or calculus; no gum swelling, inflammation or bleeding

Note: To be filled by family dentist.

6. Examination Record and Treatment Outcome(Regular Follow-up Appointments)

- To be filled by your family doctor or dentist after each regular follow-up appointment.

- Part A is applicable for patients with hypertension or diabetes. Part B is applicable for patients with diabetes only.

Date of follow-up appointment

Examination Item Treatment Target ExaminationRecord

Treatment Outcome Please give a score by

circling a star(5 stars means highest scores)

Remarks

(Part A) Patients with hypertension or diabetes

Blood pressure

Lower than 140/90mmHg for patients with hypertension

Lower than 130/80mmHgfor patients with diabetes

Life

styl

e

Diet control Follow recommendations given by doctors or other healthcareprofessionals such as dietitian

Yes / No

Regular exercise Yes / No

Smoking habit No smoking Yes / No

Oral hygiene

practice(Note) Establish proper tooth cleaning habit

Maintain teeth and gum healthyYes / No

Medication(s) Comply with doctors’ advice Yes / No

Others

(Part B) Patients with diabetes

Blo

odgl

ucos

ele

vel Fasting Blood glucose level being 4-7 mmol/L

1 or 2 hoursafter meal Blood glucose level below 10 mmol/L

Oral examination (Note) No accumulation of plaque or calculus; no gum swelling, inflammation or bleeding

Note: To be filled by family dentist.

1110

6. Examination Record and Treatment Outcome(Regular Follow-up Appointments)

- To be filled by your family doctor or dentist after each regular follow-up appointment.

- Part A is applicable for patients with hypertension or diabetes. Part B is applicable for patients with diabetes only.

Date of follow-up appointment

Examination Item Treatment Target ExaminationRecord

Treatment Outcome Please give a score by

circling a star(5 stars means highest scores)

Remarks

(Part A) Patients with hypertension or diabetes

Blood pressure

Lower than 140/90mmHg for patients with hypertension

Lower than 130/80mmHgfor patients with diabetes

Life

styl

e

Diet control Follow recommendations given by doctors or other healthcareprofessionals such as dietitian

Yes / No

Regular exercise Yes / No

Smoking habit No smoking Yes / No

Oral hygiene

practice(Note) Establish proper tooth cleaning habit

Maintain teeth and gum healthyYes / No

Medication(s) Comply with doctors’ advice Yes / No

Others

(Part B) Patients with diabetes

Blo

odgl

ucos

ele

vel Fasting Blood glucose level being 4-7 mmol/L

1 or 2 hoursafter meal Blood glucose level below 10 mmol/L

Oral examination (Note) No accumulation of plaque or calculus; no gum swelling, inflammation or bleeding

Note: To be filled by family dentist.

1312

6. Examination Record and Treatment Outcome(Regular Follow-up Appointments)

- To be filled by your family doctor or dentist after each regular follow-up appointment.

- Part A is applicable for patients with hypertension or diabetes. Part B is applicable for patients with diabetes only.

Date of follow-up appointment

Examination Item Treatment Target ExaminationRecord

Treatment Outcome Please give a score by

circling a star(5 stars means highest scores)

Remarks

(Part A) Patients with hypertension or diabetes

Blood pressure

Lower than 140/90mmHg for patients with hypertension

Lower than 130/80mmHgfor patients with diabetes

Life

styl

e

Diet control Follow recommendations given by doctors or other healthcareprofessionals such as dietitian

Yes / No

Regular exercise Yes / No

Smoking habit No smoking Yes / No

Oral hygiene

practice(Note) Establish proper tooth cleaning habit

Maintain teeth and gum healthyYes / No

Medication(s) Comply with doctors’ advice Yes / No

Others

(Part B) Patients with diabetes

Blo

odgl

ucos

ele

vel Fasting Blood glucose level being 4-7 mmol/L

1 or 2 hoursafter meal Blood glucose level below 10 mmol/L

Oral examination (Note) No accumulation of plaque or calculus; no gum swelling, inflammation or bleeding

Note: To be filled by family dentist.

1514

6. Examination Record and Treatment Outcome(Regular Follow-up Appointments)

- To be filled by your family doctor or dentist after each regular follow-up appointment.

- Part A is applicable for patients with hypertension or diabetes. Part B is applicable for patients with diabetes only.

Date of follow-up appointment

Examination Item Treatment Target ExaminationRecord

Treatment Outcome Please give a score by

circling a star(5 stars means highest scores)

Remarks

(Part A) Patients with hypertension or diabetes

Blood pressure

Lower than 140/90mmHg for patients with hypertension

Lower than 130/80mmHgfor patients with diabetes

Life

styl

e

Diet control Follow recommendations given by doctors or other healthcareprofessionals such as dietitian

Yes / No

Regular exercise Yes / No

Smoking habit No smoking Yes / No

Oral hygiene

practice(Note) Establish proper tooth cleaning habit

Maintain teeth and gum healthyYes / No

Medication(s) Comply with doctors’ advice Yes / No

Others

(Part B) Patients with diabetes

Blo

odgl

ucos

ele

vel Fasting Blood glucose level being 4-7 mmol/L

1 or 2 hoursafter meal Blood glucose level below 10 mmol/L

Oral examination (Note) No accumulation of plaque or calculus; no gum swelling, inflammation or bleeding

Note: To be filled by family dentist.

1716

6. Examination Record and Treatment Outcome(Regular Follow-up Appointments)

- To be filled by your family doctor or dentist after each regular follow-up appointment.

- Part A is applicable for patients with hypertension or diabetes. Part B is applicable for patients with diabetes only.

Date of follow-up appointment

Examination Item Treatment Target ExaminationRecord

Treatment Outcome Please give a score by

circling a star(5 stars means highest scores)

Remarks

(Part A) Patients with hypertension or diabetes

Blood pressure

Lower than 140/90mmHg for patients with hypertension

Lower than 130/80mmHgfor patients with diabetes

Life

styl

e

Diet control Follow recommendations given by doctors or other healthcareprofessionals such as dietitian

Yes / No

Regular exercise Yes / No

Smoking habit No smoking Yes / No

Oral hygiene

practice(Note) Establish proper tooth cleaning habit

Maintain teeth and gum healthyYes / No

Medication(s) Comply with doctors’ advice Yes / No

Others

(Part B) Patients with diabetes

Blo

odgl

ucos

ele

vel Fasting Blood glucose level being 4-7 mmol/L

1 or 2 hoursafter meal Blood glucose level below 10 mmol/L

Oral examination (Note) No accumulation of plaque or calculus; no gum swelling, inflammation or bleeding

Note: To be filled by family dentist.

1918

6. Examination Record and Treatment Outcome(Regular Follow-up Appointments)

- To be filled by your family doctor or dentist after each regular follow-up appointment.

- Part A is applicable for patients with hypertension or diabetes. Part B is applicable for patients with diabetes only.

Date of follow-up appointment

Examination Item Treatment Target ExaminationRecord

Treatment Outcome Please give a score by

circling a star(5 stars means highest scores)

Remarks

(Part A) Patients with hypertension or diabetes

Blood pressure

Lower than 140/90mmHg for patients with hypertension

Lower than 130/80mmHgfor patients with diabetes

Life

styl

e

Diet control Follow recommendations given by doctors or other healthcareprofessionals such as dietitian

Yes / No

Regular exercise Yes / No

Smoking habit No smoking Yes / No

Oral hygiene

practice(Note) Establish proper tooth cleaning habit

Maintain teeth and gum healthyYes / No

Medication(s) Comply with doctors’ advice Yes / No

Others

(Part B) Patients with diabetes

Blo

odgl

ucos

ele

vel Fasting Blood glucose level being 4-7 mmol/L

1 or 2 hoursafter meal Blood glucose level below 10 mmol/L

Oral examination (Note) No accumulation of plaque or calculus; no gum swelling, inflammation or bleeding

Note: To be filled by family dentist.

2120

6. Examination Record and Treatment Outcome(Regular Follow-up Appointments)

- To be filled by your family doctor or dentist after each regular follow-up appointment.

- Part A is applicable for patients with hypertension or diabetes. Part B is applicable for patients with diabetes only.

Date of follow-up appointment

Examination Item Treatment Target ExaminationRecord

Treatment Outcome Please give a score by

circling a star(5 stars means highest scores)

Remarks

(Part A) Patients with hypertension or diabetes

Blood pressure

Lower than 140/90mmHg for patients with hypertension

Lower than 130/80mmHgfor patients with diabetes

Life

styl

e

Diet control Follow recommendations given by doctors or other healthcareprofessionals such as dietitian

Yes / No

Regular exercise Yes / No

Smoking habit No smoking Yes / No

Oral hygiene

practice(Note) Establish proper tooth cleaning habit

Maintain teeth and gum healthyYes / No

Medication(s) Comply with doctors’ advice Yes / No

Others

(Part B) Patients with diabetes

Blo

odgl

ucos

ele

vel Fasting Blood glucose level being 4-7 mmol/L

1 or 2 hoursafter meal Blood glucose level below 10 mmol/L

Oral examination (Note) No accumulation of plaque or calculus; no gum swelling, inflammation or bleeding

Note: To be filled by family dentist.

2322

6. Examination Record and Treatment Outcome(Regular Follow-up Appointments)

- To be filled by your family doctor or dentist after each regular follow-up appointment.

- Part A is applicable for patients with hypertension or diabetes. Part B is applicable for patients with diabetes only.

Date of follow-up appointment

Examination Item Treatment Target ExaminationRecord

Treatment Outcome Please give a score by

circling a star(5 stars means highest scores)

Remarks

(Part A) Patients with hypertension or diabetes

Blood pressure

Lower than 140/90mmHg for patients with hypertension

Lower than 130/80mmHgfor patients with diabetes

Life

styl

e

Diet control Follow recommendations given by doctors or other healthcareprofessionals such as dietitian

Yes / No

Regular exercise Yes / No

Smoking habit No smoking Yes / No

Oral hygiene

practice(Note) Establish proper tooth cleaning habit

Maintain teeth and gum healthyYes / No

Medication(s) Comply with doctors’ advice Yes / No

Others

(Part B) Patients with diabetes

Blo

odgl

ucos

ele

vel Fasting Blood glucose level being 4-7 mmol/L

1 or 2 hoursafter meal Blood glucose level below 10 mmol/L

Oral examination (Note) No accumulation of plaque or calculus; no gum swelling, inflammation or bleeding

Note: To be filled by family dentist.

2524

6. Examination Record and Treatment Outcome(Regular Follow-up Appointments)

- To be filled by your family doctor or dentist after each regular follow-up appointment.

- Part A is applicable for patients with hypertension or diabetes. Part B is applicable for patients with diabetes only.

Date of follow-up appointment

Examination Item Treatment Target ExaminationRecord

Treatment Outcome Please give a score by

circling a star(5 stars means highest scores)

Remarks

(Part A) Patients with hypertension or diabetes

Blood pressure

Lower than 140/90mmHg for patients with hypertension

Lower than 130/80mmHgfor patients with diabetes

Life

styl

e

Diet control Follow recommendations given by doctors or other healthcareprofessionals such as dietitian

Yes / No

Regular exercise Yes / No

Smoking habit No smoking Yes / No

Oral hygiene

practice(Note) Establish proper tooth cleaning habit

Maintain teeth and gum healthyYes / No

Medication(s) Comply with doctors’ advice Yes / No

Others

(Part B) Patients with diabetes

Blo

odgl

ucos

ele

vel Fasting Blood glucose level being 4-7 mmol/L

1 or 2 hoursafter meal Blood glucose level below 10 mmol/L

Oral examination (Note) No accumulation of plaque or calculus; no gum swelling, inflammation or bleeding

Note: To be filled by family dentist.

2726

6. Examination Record and Treatment Outcome(Regular Follow-up Appointments)

- To be filled by your family doctor or dentist after each regular follow-up appointment.

- Part A is applicable for patients with hypertension or diabetes. Part B is applicable for patients with diabetes only.

Date of follow-up appointment

Examination Item Treatment Target ExaminationRecord

Treatment Outcome Please give a score by

circling a star(5 stars means highest scores)

Remarks

(Part A) Patients with hypertension or diabetes

Blood pressure

Lower than 140/90mmHg for patients with hypertension

Lower than 130/80mmHgfor patients with diabetes

Life

styl

e

Diet control Follow recommendations given by doctors or other healthcareprofessionals such as dietitian

Yes / No

Regular exercise Yes / No

Smoking habit No smoking Yes / No

Oral hygiene

practice(Note) Establish proper tooth cleaning habit

Maintain teeth and gum healthyYes / No

Medication(s) Comply with doctors’ advice Yes / No

Others

(Part B) Patients with diabetes

Blo

odgl

ucos

ele

vel Fasting Blood glucose level being 4-7 mmol/L

1 or 2 hoursafter meal Blood glucose level below 10 mmol/L

Oral examination (Note) No accumulation of plaque or calculus; no gum swelling, inflammation or bleeding

Note: To be filled by family dentist.

2928

6. Examination Record and Treatment Outcome(Regular Follow-up Appointments)

- To be filled by your family doctor or dentist after each regular follow-up appointment.

- Part A is applicable for patients with hypertension or diabetes. Part B is applicable for patients with diabetes only.

Date of follow-up appointment

Examination Item Treatment Target ExaminationRecord

Treatment Outcome Please give a score by

circling a star(5 stars means highest scores)

Remarks

(Part A) Patients with hypertension or diabetes

Blood pressure

Lower than 140/90mmHg for patients with hypertension

Lower than 130/80mmHgfor patients with diabetes

Life

styl

e

Diet control Follow recommendations given by doctors or other healthcareprofessionals such as dietitian

Yes / No

Regular exercise Yes / No

Smoking habit No smoking Yes / No

Oral hygiene

practice(Note) Establish proper tooth cleaning habit

Maintain teeth and gum healthyYes / No

Medication(s) Comply with doctors’ advice Yes / No

Others

(Part B) Patients with diabetes

Blo

odgl

ucos

ele

vel Fasting Blood glucose level being 4-7 mmol/L

1 or 2 hoursafter meal Blood glucose level below 10 mmol/L

Oral examination (Note) No accumulation of plaque or calculus; no gum swelling, inflammation or bleeding

Note: To be filled by family dentist.

3130

3332

7. Examination Record and Treatment Outcome(Annual Assessment)

- To be filled by your family doctor or dentist after each annual assessment.

- Part A is applicable for patients with hypertension or diabetes. Part B is applicable for patients with diabetes only.

Date of annual assessment

Examination Item Treatment Target ExaminationRecord

Treatment Outcome Please give a score by

circling a star(5 stars means highest scores)

Remarks

(Part A) Patients with hypertension or diabetes

Height (m)

Weight (kg) Maintain ideal weight

Body Mass Index (BMI) Below 23 kg/m2

Waist circumferenceMale: less than 90 cmFemale: less than 80 cm

Blood pressure

Lower than 140/90mmHgfor patients with hypertension

Lower than 130/80mmHgfor patients with diabetes

Life

styl

e

Diet control Follow recommendations given by doctors or other healthcare professionals such as dietitian

Yes / No

Regular exercise Yes / No

Smoking habit No smoking Yes / No

Oral hygiene (Note)

practiceEstablish proper tooth cleaning habitMaintain teeth and gum healthy Yes / No

Medication(s) Comply with doctors’ advice Yes / No

Influenza vaccine Annual injection Yes / No

Others

Note: To be filled by family dentist.

3534

7. Examination Record and Treatment Outcome(Annual Assessment)

Date of annual assessment

Examination Item Treatment Target ExaminationRecord

Treatment Outcome Please give a score by

circling a star(5 stars means highest scores)

Remarks

(Part B) Patients with diabetes

Blo

od

glu

cose

leve

l

Fasting Blood glucose levelbeing 4-7 mmol/L

1 or 2 hoursafter meal

Blood glucose levelbelow 10 mmol/L

Glycatedhaemogloblin Below 7%

Blo

od

lip

id le

vel

Totalcholesterol Below 4.5 mmol/L

High DensityLipoprotein (HDL)- cholesterol

Male: above 1 mmol/LFemale: above 1.3 mmol/L

Low Density Lipoprotein (LDL)- cholesterol

Below 2.6 mmol/L

Triglyceride Below 1.7 mmol/L

Renal function test

Eye examination

Foot examination

Urine protein test

(Note)Oral examinationNo accumulation of plaque or calculus; no gum swelling, inflammation or bleeding

Note: To be filled by family dentist.

3736

7. Examination Record and Treatment Outcome(Annual Assessment)

- To be filled by your family doctor or dentist after each annual assessment.

- Part A is applicable for patients with hypertension or diabetes. Part B is applicable for patients with diabetes only.

Date of annual assessment

Examination Item Treatment Target ExaminationRecord

Treatment Outcome Please give a score by

circling a star(5 stars means highest scores)

Remarks

(Part A) Patients with hypertension or diabetes

Height (m)

Weight (kg) Maintain ideal weight

Body Mass Index (BMI) Below 23 kg/m2

Waist circumferenceMale: less than 90 cmFemale: less than 80 cm

Blood pressure

Lower than 140/90mmHgfor patients with hypertension

Lower than 130/80mmHgfor patients with diabetes

Life

styl

e

Diet control Follow recommendations given by doctors or other healthcare professionals such as dietitian

Yes / No

Regular exercise Yes / No

Smoking habit No smoking Yes / No

Oral hygiene (Note)

practiceEstablish proper tooth cleaning habitMaintain teeth and gum healthy Yes / No

Medication(s) Comply with doctors’ advice Yes / No

Influenza vaccine Annual injection Yes / No

Others

Note: To be filled by family dentist.

3938

7. Examination Record and Treatment Outcome(Annual Assessment)

Date of annual assessment

Examination Item Treatment Target ExaminationRecord

Treatment Outcome Please give a score by

circling a star(5 stars means highest scores)

Remarks

(Part B) Patients with diabetes

Blo

od

glu

cose

leve

l

Fasting Blood glucose levelbeing 4-7 mmol/L

1 or 2 hoursafter meal

Blood glucose levelbelow 10 mmol/L

Glycatedhaemogloblin Below 7%

Blo

od

lip

id le

vel

Totalcholesterol Below 4.5 mmol/L

High DensityLipoprotein (HDL)- cholesterol

Male: above 1 mmol/LFemale: above 1.3 mmol/L

Low Density Lipoprotein (LDL)- cholesterol

Below 2.6 mmol/L

Triglyceride Below 1.7 mmol/L

Renal function test

Eye examination

Foot examination

Urine protein test

(Note)Oral examinationNo accumulation of plaque or calculus; no gum swelling, inflammation or bleeding

Note: To be filled by family dentist.

////////

4140

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8. Blood Pressure Record(To be filled by oneself)

- If your family doctor asks you to measure blood pressure at home, you may use the following table to record the readings.

- If the reading differs from the usual ones, please identify possible reasons and mark them under remarks.

Date Blood Pressure

(mmHg) Remarks

Example: 12.4.2011 170 /90 Had a flu

Example: 22.4.2011 160/90 Sleeping problem; worried about family

My blood pressure target: / mmHg

Date Blood Pressure

(mmHg) Remarks

8. Blood Pressure Record(To be filled by oneself)

My blood pressure target: / mmHg

Date Blood Pressure

(mmHg) Remarks

4342

//////////////////

8. Blood Pressure Record(To be filled by oneself)

My blood pressure target: / mmHg

Date Blood Pressure

(mmHg) Remarks

9. Blood Glucose Record(To be filled by oneself)

- If your family doctor asks you to measure blood glucose at home, you may use the following table to record the readings.

- If the reading differs from the usual ones, please identify possible reasons and mark them under remarks.

Date

Blood glucose level (unit: mmol/L)

RemarksBreakfast Lunch Dinner Beforebedbefore after before after before after

Example:12.4.2011 5 13 Ate more than usual

during breakfast

Example:18.4.2011 4.2 3.8 Only drank a glass

of milk for breakfast

Example:28.4.2011 6 8.5 9.2 9.6

4544

9. Blood Glucose Record(To be filled by oneself)

My blood glucose target:

Fasting: _____ mmol/L 2 hours after meal: ______ mmol/L

Date

Blood glucose level (mmol/L)

RemarksBreakfast

before after

Lunch

before after

Dinner

before afterBefore

bed

9. Blood Glucose Record(To be filled by oneself)

My blood glucose target:

Fasting: _____ mmol/L 2 hours after meal: ______ mmol/L

Date

Blood glucose level (mmol/L)

RemarksBreakfast

before after

Lunch

before after

Dinner

before afterBefore

bed

4746

9. Blood Glucose Record(To be filled by oneself)

My blood glucose target:

Fasting: _____ mmol/L 2 hours after meal: ______ mmol/L

Date

Blood glucose level (mmol/L)

RemarksBreakfast

before after

Lunch

before after

Dinner

before afterBefore

bed

10. Health Commitment

Do you want to be healthy? Please discuss with your family doctor or dentist your health promotion plan every year and make an effort to achieve it.

Date:

In the next 12 months, I will meet these targets:(Please tick against the items)

Eat less salty food

Eat less fried food; use less oil in cooking

No over eating

Eat out less often; prepare lunch by myself

Eat more high fibre food such as vegetables, fruits and whole grains

Drink less alcohol

Exercise regularly

Comply with doctor’s advice on medication(s)

Relax yourself

Sleep and get up early

Quit smoking

Brush and clean teeth properly and thoroughly, in the morning and at night

Use toothbrush with soft bristles and fluoride toothpaste

Use dental floss or interdental brush to clean the adjacent surfaces of teeth

4948

10. Health Commitment

Do you want to be healthy? Please discuss with your family doctor or dentist your health promotion plan every year and make an effort to achieve it.

Date:

In the next 12 months, I will meet these targets:(Please tick against the items)

Eat less salty food

Eat less fried food; use less oil in cooking

No over eating

Eat out less often; prepare lunch by myself

Eat more high fibre food such as vegetables, fruits and whole grains

Drink less alcohol

Exercise regularly

Comply with doctor’s advice on medication(s)

Relax yourself

Sleep and get up early

Quit smoking

Brush and clean teeth properly and thoroughly, in the morning and at night

Use toothbrush with soft bristles and fluoride toothpaste

Use dental floss or interdental brush to clean the adjacent surfaces of teeth

11. Resource corner

Smoking Cessation Service

Service Organisation Telephone number

Integrated Smoking Cessation Hotline of the Department of Health

Department of Health 1833 183 (press 1)

Hospital Authority Quitline Hospital Authority 1833 183 (press 3)2300 7272

Tung Wah Smoking Cessation Hotline

Tung Wah Groups ofHospitals

1833 183 (press 2)2332 8977

Pok Oi Smoking Cessation Service using Traditional Chinese Medicine

Pok Oi Hospital 1833 183 (press 4) 2607 1222

HKU Youth Quitline The University of Hong Kong

1833 183 (press 5)2855 9557

Related WebsiteOral Health Education Unit

Department of Health http://www.toothclub.gov.hk/

Central Health Education Unit,

Department of Health http://www.cheulgov.hk/

Chinese Medicine Division,

Department of Health http://www.cmdlgov.hk/

Smart Patient, Hospital Authority http://www21.ha.org.hk/

Health Service HotlinesOral Health Education Unit, Department of Health 2713 6344

24-hour Health Education Hotline, Central Health

Education Unit, Department of Health 2833 0111

Chinese Medicine Division, Department of Health 2574 9999