Submitted by Dave Lunn     

My last visit to the hospital was in the 2021 in the midst of the pandemic. Breathing was difficult and I suspected a COVID infection. When I was admitted to emergency and tested it turned out I had pneumonia and not COVID.

I gave the emergency doctor my health/medical information on the charts below. Needless to say, he was most impressed and guessed I must be an engineer. Alas not I told him, just a retired biology teacher. He assured me I wouldn’t be leaving hospital until I was healthy. Eight days later after many tests and excellent care, I did leave.

My point in sharing this is that it not only provides your health care provider with important information that may hasten your treatment, but just as important, it shows the health provider that you are wanting to help them understand your medical information both past and present. 

I know much of this information is available to doctors online through the Alberta Health Services (AHS) web site, but having a printed sheet is more immediate and perhaps gives additional information that’s not with AHS.

Since this my hospital visit, I’ve joined the Alberta Surgical Initiative of Alberta Health Services as a Patient and Family Advisor. This is to provide the patient’s perspective to the referral process for the urology, endoscopy, and general surgery groups with Calgary, Edmonton, and provincial sections. As part of this work I was asked to present my hospital visit in video format as a ‘good news’ story for doctors and other health care staff. This can be seen online HERE 

 Health/Medical Information


Address. Phone numbers, Email

Date of Birth, AHC No. Blue Cross Number. Other Health Insurance Number, Driver’s Licence No.

MyHealth log-in

Contacts: In case of Emergency, Phone, Email. Personal Support:

Mobility needs: Cane, Walker, Wheelchair

Hearing Aids:

Languages Spoken/read:

List of Surgeries and Procedures





Locations (City)
















Chronic Condition(s)














Medication Name












Hepatitis A & B Twinrix (3 shots)


Pneumonia – Pneumovax, Prevnar


Diphtheria, Tetanus, Pertussis


Zostavax, Shingrix


Influenza Standard or High Dose

October annually

Type of COVID 19 vaccinations 1st & 2nd


Type of COVID 19 vaccinations 1st, 2nd, & 3rd boosters


Eye Rx Name, Date of last exam, Optometrist, Ophthalmologist

Right eye


Left eye


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