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  The following tools will assist you in assessing your patient's readiness for a weight-loss regimen. Patient Weight-Loss Worksheet (14KB)  HTML version This worksheet can help facilitate a productive discussion with your patient about his or her weight-loss history, goals and options. The information gathered will help you determine the most appropriate weight-loss approach for your patient and may also shed some light on potential obstacles to compliance. Simply print out the worksheet and ask the patient to complete it during his or her office visit. Weight-Management Goals and Patient/Physician Contract (8KB) Unless your patient believes that he or she will be successful and is fully committed to the behavioral changes necessary to lose weight, the likelihood of failure is considerable. Developing a sense of partnership with a patient is essential for a successful outcome. This form can be an effective tool in helping you and your patient establish clear, agreed-upon weight-loss goals and formally agree to achieve them. Simply print out this form and ask the patient to read it over. Once you have determined a treatment course, established a regimen and discussed it with your patient, you and the patient can sign it together. Daily Diary This two-page take-home form consists of a food diary and a personal journal for at-risk patients to keep track of their meals and activity levels over a week's time. This information will enable you to get a clear picture of what a patient's dietary habits and activity levels are really like. Simply print out these forms and ask the patient to fill them out and bring them to the follow-up visit. How to Keep a Food Diary (49K)
HTML version How to Keep a Personal Journal (51K)
HTML version Roche Laboratories invites you to use these resources on your own Web site. Remember that your local Roche representative has numerous tools and teaching aids to assist you in diagnosing, educating and treating patients. To view and print PDF documents, you will need the Adobe Acrobat Reader installed, which you can download from the Adobe Systems Web site. If this link does not work, then try Adobe's main Web site at www.adobe.com.  | ||||
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