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Form BP-A670 060, Diabetes Flow Sheet

Form BP-A670 060, Diabetes Flow Sheet 2025

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The document is a diabetes flow sheet used by the U.S. Department of Justice's Federal Bureau of Prisons to record essential health data for diabetic patients during clinic visits. It includes sections for tracking smoking habits, exercise frequency, foot checks, weight, blood pressure, pulse, glucose levels, and various lab results. Additionally, it provides a key for comments regarding patient education and compliance.

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Click ‘Get Form’ to open the Diabetes Flow Sheet in our editor.
Begin by entering the patient's name, registration number, date of birth, and institution at the top of the form. This information is essential for proper identification.
Record vital data during each clinic visit. Fill in the 'Date' field and document smoking habits (cigs/day), exercise frequency (days/week), and foot check status (Y/N).
Input weight, blood pressure (BP), pulse, and glucose levels in their respective fields. Ensure accuracy as these metrics are crucial for diabetes management.
List current medications and their doses at the end of each visit. Use the comments section to note any significant observations or changes.
For fundoscopic results, indicate the date and whether it was normal or abnormal. Repeat this for cholesterol/HDL, creatinine, urinalysis, and microalbumin tests.
Utilize the key to comments section to clarify any notes regarding patient compliance or education provided during visits.

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