# The Health and Medical Module

The FIRM Guide (thefirmguide.com) — companion to The Recoverable Family.
Fill this in privately (any text editor or by hand), then store it in your Vault.


## Secure Guide Starter Template

> Store this inside your Vault. Record the date of the last review at the top, then keep each section current.

- Last reviewed: 

### Medications
| Name | Dosage | Frequency | Prescribing Provider | Pharmacy |
| --- | --- | --- | --- | --- |
|   |   |   |   |   |
|   |   |   |   |   |
|   |   |   |   |   |

### Known Allergies
| Substance | Reaction |
| --- | --- |
|   |   |
|   |   |
|   |   |

### Chronic Conditions / Ongoing Care
| Condition | Managing Provider | Notes |
| --- | --- | --- |
|   |   |   |
|   |   |   |
|   |   |   |

### Medical Providers
| Role | Name | Practice | Phone | Patient Portal |
| --- | --- | --- | --- | --- |
|   |   |   |   |   |
|   |   |   |   |   |
|   |   |   |   |   |

> Patient portal credentials are stored in The Vault.

### Health Insurance
| Type | Carrier | Plan Name | Member ID | Group # | Member Services |
| --- | --- | --- | --- | --- | --- |
|   |   |   |   |   |   |
|   |   |   |   |   |   |
|   |   |   |   |   |   |

> Insurance portal credentials are stored in The Vault.

### Advance Directives
| Document | Date Executed | Storage Location | Who Has Copies |
| --- | --- | --- | --- |
|   |   |   |   |
|   |   |   |   |
|   |   |   |   |

> See the Estate Plan Module for formal legal context.

### HIPAA Release Authorizations
| Authorized Person | Relationship | On File With | Date Authorized |
| --- | --- | --- | --- |
|   |   |   |   |
|   |   |   |   |
|   |   |   |   |


## Family Guide Starter Template

> For use by family members, caregivers, or first responders. This template contains no sensitive credentials.

- Primary Care Physician: 

- Phone: 

- Preferred Hospital / Health System: 

- Known Allergies: 

- Current Medications: 

- Carrier: 

- Member Services: 

- Insurance card location: 

- Living will and healthcare proxy are located at: 

- Authorized healthcare decision-maker: 

- Contact: 

- Pharmacy Name: 

- Phone: 

- Address: 

### Notes for Family Members