Paper $4.95 USD, Reusable $4.95 USD
Helps with record keeping and
makes it easier to notice trending.
On the back, you can track your
Both formats – Reusable or Notebook
Reusable laminated, wipes off with
(Photocopy, scan or take a picture,
then wipe off and start over.)
Notebook style – 6 months paper logs
3-hole punched for binder
Disclaimer: All paper, chart and/or electronic formats and information are provided for the sole convenience of the user. HD Merrimack makes no warranties or representations about the product or the supplied forms. There may be state specific and physician signed forms the user needs to obtain, not included in the information provided. The forms provided are guidelines only. The user assumes all responsibility for use of this product, including all information the user puts on the forms and the accuracy of said information as well as any documents inserted/not inserted in this product.