Caregiver Journal

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CAREGIVER JOURNAL

Caregiver Journal

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Week 1

Medicines given

Questions to ask before week 2

Call your doctor right away if you have a side effect that bothers you, that doesn’t go away, or for medical advice. You may also report side effects to United Therapeutics Corporation at DrugSafety@Unither.com or by contacting FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

Notes/Observations at home

Notes/Observations in hospital

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Week 2

Medicines given

Caregiver Journal

Questions to ask before week 3

Notes/Observations at home

Notes/Observations in hospital

Call your doctor right away if you have a side effect that bothers you, that doesn’t go away, or for medical advice. You may also report side effects to United Therapeutics Corporation at DrugSafety@Unither.com or by contacting FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

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Week 3

Medicines given

Caregiver Journal

Questions to ask before week 4

Notes/Observations at home

Notes/Observations in hospital

Call your doctor right away if you have a side effect that bothers you, that doesn’t go away, or for medical advice. You may also report side effects to United Therapeutics Corporation at DrugSafety@Unither.com or by contacting FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

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Week 4

Medicines given

Caregiver Journal

Questions to ask before week 5

Notes/Observations at home

Notes/Observations in hospital

Call your doctor right away if you have a side effect that bothers you, that doesn’t go away, or for medical advice. You may also report side effects to United Therapeutics Corporation at DrugSafety@Unither.com or by contacting FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

Caregiver Journal

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Week 5

Medicines given

Caregiver Journal

Questions to ask before week 6

Notes/Observations at home

Notes/Observations in hospital

Call your doctor right away if you have a side effect that bothers you, that doesn’t go away, or for medical advice. You may also report side effects to United Therapeutics Corporation at DrugSafety@Unither.com or by contacting FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

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Week 6

Medicines given

Caregiver Journal

Questions to ask

Notes/Observations at home

Notes/Observations in hospital

Call your doctor right away if you have a side effect that bothers you, that doesn’t go away, or for medical advice. You may also report side effects to United Therapeutics Corporation at DrugSafety@Unither.com or by contacting FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

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Doctor (Name)

Phone

E-mail

Nurse (Name)

Phone

E-mail

Hospital Name

Phone

E-mail

Pharmacy Name

Phone

E-mail

Use this space to keep track of the contact information for your child’s healthcare team.

Caregiver Journal

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Caregiver Journal

Notes

© 2017 United Therapeutics Corporation. All rights reserved. US/DS/0071 Printed in USA.