Superior Co-Living Monthly Weight and Vitals

Superior Co-Living Monthly

Weight and Vitals
Resident Name:

Type a question

	DATE	TEMP	PUL	RES	BP	WT	INITIALS	COMMENTS
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEPT
OCT
NOV
DEC

ANY WEIGHT LOSS OF 5% OR MORE MUST BE BROUGHT TO THE ATTENTION OF THENURSE AND/OR ADMINISTRATOR.

PLEASE NOTIFY PHYSICIAN IMMEDIATELY

FOLLOW EQUATION BELOW

PREVIOUS WEIGHT (-) CURRENT WEIGHT = X X ÷ PREVIOUS WEIGHT=ANSWER (X) 100% WEIGHT LOSS
Should be Empty: