Author: mark tripp

This is my Hospital Passport. It contains important information about me and 22q11.
Please Consult this Passport before you assess or carry out any medical interventions

Name:
But you can call me:
Date of birth:
NHS Number:

If I have to stay in Hospital and you have matters that need dealing with urgently please can you contact the following people:
Names:
Relationship:
Contact No’s

My Heart history is:

Please be aware of the following Mental Health/Behavioural issues:

How you can help me understand and make choices:

The following can make me anxious:

There are close to 200 known medical anomalies associated to 22q11. Here are some of the medical treatments/surgeries I have had:

This is a list of my current medication:
Before changing any of my medicines you may wish to consult with the following :
Name: or &
Contact:

Things that I like :

Things that I dislike:

Other information you may want to know about me:

My Positives and Strengths

Thank you for taking the time to read my Health Passport, please can you help me further by ensuring this is read by all your colleagues by placing it with my medical notes.
Please hand it back to me at the end of my appointment or at the time of my discharge.
If you require any further information regarding 22q11 conditions please see www.maxappeal.org.uk where you can download resources including a consensus document which was designed and written by over 50 medical experts to compile a comprehensive and universally agreed lifelong care plan for people with 22q11DS within the framework of the NHS.
Alternatively you can email info@maxappeal.org.uk for further information

© Max Appeal, 15 Meriden Avenue, Wollaston, Stourbridge, West Midlands, DY8 4QN, Tel: 0300 999 2211 Registered Charity No. 1088432