My health passport. Page. Content. 1. Information of My Family Doctor Information of My Family Dentist 3

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2 My health passport The aim of this passport is to help you record down the information of your family doctor, dentist or Chinese medicine practitioner. It is also your personal health record. Please keep it properly. Please remember to bring along your health passport for every health visits. This will help your family doctor, dentist, Chinese medicine practitioner and other healthcare professionals understand your health conditions and facilitate discussion of your health promotion plan. Content Page 1. Information of My Family Doctor 2 2. Information of My Family Dentist 3 3. Information of My Family Chinese Medicine Practitioner 4 4. My Personal Health Information 5 5. My Consultation Record (Family Doctor) 6 6. My Consultation Record (Family Dentist) 8 7. My Consultation Record 9 (Family Chinese Medicine Practitioner) 8. Tips for Healthy Lifestyle Health Reference Index Health Commitment Resource Corner 20 1

3 1. Information of My Family Doctor (To be filled by your family doctor) 2. Information of My Family Dentist (To be filled by your family dentist) My family doctor: (Name) My family dentist: (Name) Please affix the name card of your family doctor. Please affix the name card of your family dentist. My family doctor has joined the following primary care schemes: My family dentist has joined the following primary care scheme: Health Care Voucher Scheme Yes/No Health Care Voucher Scheme Yes/No Elderly Vaccination Subsidy Scheme Yes/No 2 3

4 3. Information of My Family Chinese Medicine Practitioner (To be filled by your family Chinese medicine practitioner) 4. My Personal Health Information (To be filled by oneself) My family Chinese medicine practitioner: (Name) Date of birth : Sex : Address : Please affix the name card of your family Chinese medicine practitioner. My family Chinese medicine practitioner has joined the following primary care scheme: Health Care Voucher Scheme Yes/No Telephone : Blood type : Medical history : Drug allergy (Western medicines / Chinese medicines): Food allergy : Long-term medication(s) (Western medicines / Chinese medicines): Emergency contact In case of emergency, please contact the following persons: Name Relationship Telephone number 4 5

5 5. My Consultation Record (Family Doctor) (To be filled by oneself) 5. My Consultation Record (Family Doctor) (To be filled by oneself) Date Time Diagnosis Date Time Diagnosis 6 7

6 6. My Consultation Record (Family Dentist) (To be filled by oneself) 7. My Consultation Record (Family Chinese Medicine Practitioner) (To be filled by oneself) Date Time Diagnosis Date Time Diagnosis 8 9

7 7. My Consultation Record (Family Chinese Medicine Practitioner) (To be filled by oneself) 8. Tips for Healthy Lifestyle Date Time Diagnosis Adopt healthy eating habit Eat a balanced diet; maintain ideal body weight Ensure balanced nutrition and eat more high fibre food such as vegetables, fruits, whole wheat bread and brown rice Adopt healthy cooking methods like steaming, poaching or boiling Reduce intake of high fat food such as animal fat and skins, fried food, whole milk, cakes or coconut milk Pay attention to the values of fats, sodium (or salt) and sugar on nutrition labels. Choose food lower in fats, sodium and sugars. Increase physical activities Exercise for at least half an hour daily; or Exercise for at least one hour every other day; or Accumulate 30 minutes of physical activities daily (not less than 10 minutes each time). Reduce alcohol intake No more than 2 standard drinks daily for male No more than 1 standard drink daily for female 10 11

8 8. Tips for Healthy Lifestyle 8. Tips for Healthy Lifestyle A standard drink (note 1) equals to: ml of beer (5% alcohol) - 1 small glass (100 ml) of wine (12% alcohol) - 1 pub measure (30 ml) of spirits (40% alcohol) Quit smoking Non-smokers should not try smoking and smokers should quit immediately If you need help to quit smoking, please refer to Resource Corner Relax your Stay relaxed; don't be too stressful body and mind Oral hygiene Brush your teeth properly twice a day Use toothbrush with soft bristles and fluoride toothpaste Clean all surfaces of your teeth properly, i.e. the outer, inner and chewing surfaces; and gently brush the gumline Use dental floss or interdental brush to clean space between teeth Health Preservation in Chinese Medicine The key concept of health preservation in Chinese medicine is preventing disease before its occurrence, which means to promote health, prevent diseases and enhance longevity in accordance with the theories of Chinese medicine. 1. Maintain a healthy mental state Learn to maintain a balanced state of mind, stay relaxed, calm and happy 2. Adapt to the nature and seasonal changes Spring : preserve yang qi; select mild and relaxing outdoor activity; eat light Summer : prevent summerheat; prevent excessive consumption of body fluids; eat light; avoid raw and cold food Autumn : preserve body fluids; maintain indoor humidity; gradually put on more clothes to keep warm; eat food that replenishes yin and moisten dryness, e.g. pear, honey etc. Winter : keep warm; take hot food and beverages; avoid excessive spicy food 3. Exercise regularly Choose suitable types of exercise and exercise regularly Note 1: A standard drink contains 10g of pure alcohol

9 8. Tips for Healthy Lifestyle 9. Health Reference Index 4. Maintain a healthy diet Pay attention to food hygiene Beware of dietary contraindications. For examples, those with heat body constitution should avoid eating excessive hot and spicy food, such as chilli, chives and ginger, etc; elderly people should protect their spleen and stomach, eat light, take soft and warm food. Eat a balanced diet with appropriate temperature and suitable amount of food at regular time. Don't be a picky eater 5. Maintain a controlled and healthy sex life Maintain a controlled and healthy sex life to avoid excessive use of kidney-essence which may lead to poor health or premature aging 6. Health-strengthening massage Massage body parts or acupoints in a balanced and soft manner; consult your family Chinese medicine practitioner for detailed manipulation You may check your weight, blood pressure, glucose level, oral hygiene and body conditions against the following indices to see if you are doing well. If you have chronic diseases, your reference indices may differ. 2 (note 2) Body Mass Index (BMI) Below 23 kg/m Blood pressure Health Reference Indices Below 140/90 mmhg (note 3) Glucose level Fasting level below 6.1 mmol/l Oral hygiene Body condition No plaque or calculus accumulating on teeth or gum; no swelling, inflammation or bleeding gum. With a conscious and clear mind; bright eyes; bright complexion; regular breathing pale red tongue; thin white coating on the tongue; normal voice; clear speech; and no abnormal smell Note 2: Body Mass Index (BMI) is defined as the weight in kilograms divided by the square of the height in metres. World Health Organization recommended Body Mass Index (BMI) cut-off points for overweight as 25 kg/m 2 and obesity as 30 kg/m 2 in For Asian populations, the BMI cut-off points of 23 kg/m 2 and 27.5 kg/m 2 were added as points for public health action. Central obesity (for Chinese) is defined as waist circumference for man equal to or more than 90 cm and for woman equal to or more than 80 cm. Note 3: Fasting is defined as no food intake for 8 hours or more. The above information is for reference only. If you have any query, please consult your family doctor, dentist or Chinese medicine practitioner

10 10. Health Commitment 10. Health Commitment Do you want to be healthy? Please discuss with your family doctor, dentist or Chinese medicine practitioner 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) Sleep and get up early; make a habit of working in daytime and resting at night; adapt to seasonal changes; Stay relaxed, calm, happy and ventilate _negative emotion Brush and clean teeth properly and thoroughly, day and night Use toothbrush with soft bristles and fluoride toothpaste Use dental floss or interdental brush to clean space between teeth Eat less salty food Eat less fried food; use less oil in cooking No over eating Dine out less often; prepare lunch by myself Eat more high fibre food such as vegetables, fruits and whole grains food Observe food hygiene; beware of dietary contraindications; eat a balanced diet with appropriate temperature and amount at regular time Choose suitable types of exercise and exercise regularly Massage body parts or acupoints in a balanced and soft manner Quit smoking Drink less alcohol Maintain a controlled and healthy sex life Follow doctor's advice on medication(s) Do you want to be healthy? Please discuss with your family doctor, dentist or Chinese medicine practitioner 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) Sleep and get up early; make a habit of working in daytime and resting at night; adapt to seasonal changes; Stay relaxed, calm, happy and ventilate _negative emotion Brush and clean teeth properly and thoroughly, day and night Use toothbrush with soft bristles and fluoride toothpaste Use dental floss or interdental brush to clean space between teeth Eat less salty food Eat less fried food; use less oil in cooking No over eating Dine out less often; prepare lunch by myself Eat more high fibre food such as vegetables, fruits and whole grains food Observe food hygiene; beware of dietary contraindications; eat a balanced diet with appropriate temperature and amount at regular time Choose suitable types of exercise and exercise regularly Massage body parts or acupoints in a balanced and soft manner Quit smoking Drink less alcohol Maintain a controlled and healthy sex life Follow doctor's advice on medication(s) 16 17

11 10. Health Commitment 10. Health Commitment Do you want to be healthy? Please discuss with your family doctor, dentist or Chinese medicine practitioner 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) Sleep and get up early; make a habit of working in daytime and resting at night; adapt to seasonal changes; Stay relaxed, calm, happy and ventilate _negative emotion Brush and clean teeth properly and thoroughly, day and night Use toothbrush with soft bristles and fluoride toothpaste Use dental floss or interdental brush to clean space between teeth Eat less salty food Eat less fried food; use less oil in cooking No over eating Dine out less often; prepare lunch by myself Eat more high fibre food such as vegetables, fruits and whole grains food Observe food hygiene; beware of dietary contraindications; eat a balanced diet with appropriate temperature and amount at regular time Choose suitable types of exercise and exercise regularly Massage body parts or acupoints in a balanced and soft manner Quit smoking Drink less alcohol Maintain a controlled and healthy sex life Follow doctor's advice on medication(s) Do you want to be healthy? Please discuss with your family doctor, dentist or Chinese medicine practitioner 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) Sleep and get up early; make a habit of working in daytime and resting at night; adapt to seasonal changes; Stay relaxed, calm, happy and ventilate _negative emotion Brush and clean teeth properly and thoroughly, day and night Use toothbrush with soft bristles and fluoride toothpaste Use dental floss or interdental brush to clean space between teeth Eat less salty food Eat less fried food; use less oil in cooking No over eating Dine out less often; prepare lunch by myself Eat more high fibre food such as vegetables, fruits and whole grains food Observe food hygiene; beware of dietary contraindications; eat a balanced diet with appropriate temperature and amount at regular time Choose suitable types of exercise and exercise regularly Massage body parts or acupoints in a balanced and soft manner Quit smoking Drink less alcohol Maintain a controlled and healthy sex life Follow doctor's advice on medication(s) 18 19

12 Resource 1 Corner 1. Smoking cessation service Service Organisation Telephone number Integrated Smoking Cessation Hotline of the Department of Health Department of Health (press 1) Hospital Authority Quitline Hospital Authority (press 3) Women Smoking Cessation Service The University of Hong Kong Tung Wah Groups of Hospitals Smoking Cessation Hotline Tung Wah Groups of Hospitals (press 2) Pok Oi Smoking Cessation Service using Traditional Chinese Medicine Pok Oi Hospital (press 4) Related Websites Oral Health Education Unit, Department of Health Central Health Education Unit, Department of Health Chinese Medicine Division, Department of Health Smart Patien1, Hospital Authority Health Service Hotlines Oral Health Education Unit, Departmen1 of Health hour Health Education Hotline, Central Health Education Unit, Department of Health Chinese Medicine Division, Department of Health