You can print or download files to replenish worksheets and forms in your copy of the Every Victory Counts® manual here.
You will need to have Adobe Acrobat Reader installed on your computer. Click here to download a free copy of Adobe Acrobat Reader.
Please click here to read an important message before downloading and/or utilizing any of the materials below.
Use of these online materials is at your own and sole risk. Always consult your doctor before making any changes to your diet and/or exercise routine.
- Wellness Worksheet - Record areas you would like to improve and steps you will take for improvement. Next, pick the top three items you listed that you would like to achieve and help prioritize your wellness work.
- Pre-Exercise Worksheet - Pre-exercise screening is a process that enables a doctor to review an individual's medical and exercise history and assess risk factors that may impact health and safety when engaging in an exercise program.
- Exercise Journal - Use this form to record your daily exercise activity. Make additional copies to help you keep track of your progress over time.
- Nutrition Worksheet - Daily recommendations and specific suggestions on how to maintain a healthy diet. Also included is information on antioxidants and their health benefits.
- Mood and Behavior: Anxiety Worksheet - Identify your stressors and anxiety, treat your anxiety, and reduce stimulants. Learn and implement relaxation or stress management techniques.
- Mood and Behavior: Depression Worksheet - Identify your mood triggers; treat your depression; add fun, pleasure and positive energy to your life; change your habits; stay connected
- Brain Health & Memory Worksheet - Visit your community or senior center to see what programs are available to you and your family. Ask your healthcare provider for a referral to an occupational, recreation, art, music or physical therapist to help you get started with recommendations.
- Constipation Worksheet - Dietary changes, lifestyle changes, medicine recommendations, and other treatments for constipation.
- Fatigue Worksheet - Lifestyle changes, dietary changes, and treatment for fatigue.
- Insomnia and Sleep Worksheet - Sleep hygiene, dietary changes, lifestyle changes, bed comfort, and treatment for insomnia and sleep habits.
- Low Blood Pressure or Dizziness Worksheet - Diet, lifestyle, and treatment for low blood pressure and dizziness.
- Overactive Bladder Worksheet - Dietary changes, lifestyle changes, and treatments for an overactive bladder.
- Gait, Balance and Freezing Worksheet - Physical exercise and training, lifestyle and good habits, dietary changes, treatment, and tips for gait, balance and freezing.
- Speech and Communication Worksheet - Speaking tips, breathing tips, communication tips, and treatment for speech and communication.
- Swallowing Worksheet - Swallowing tips, lifestyle changes, and dietary tips for swallowing.
- Prepare for Your Hospital Stay Worksheet - Information regarding medications, symptoms and advanced directives in preparation for your hospital stay. Also included is a list of what to inform, ask, and know during your hospitalization.
- Relationships and Intimacy Communication Worksheet - Make time to talk openly and honestly about the relationship, because communication is crucial.
- Deep Brain Stimulation (DBS) Self-Assessment Worksheet - One of the most important discussions you can have with your doctor and your family before considering or undergoing DBS surgery is about defining realistic expectations.
- Doctor Contact Information - List your primary care doctor, neurologist, and other providers/specialists.
- Goal Summary for Clinic Visits - The best way to improve your health is by being an active participant rather than a spectator. Record your actions and progress.
- Parkinson's Care Questionnaire - Prepare for your visit to your Parkinson's healthcare provider by filling out this questionnaire in advance.
- Medication Log - List all of your medications and keep track of when you are taking them daily. Then rate your symptoms.
- Daily Diary of Symptoms and Medications - Use this diary to keep track of your daily medications, dyskinesia, and when you feel "off."
- Symptom Checklist - This checklist will help other medical specialists, therapists or your hospital team optimize your care.
- Common Parkinson's & Medication Symptoms Worksheet - Use this body map to circle symptoms or problem areas that you would like to discuss with your doctor or other member of your healthcare team. Bring the worksheet to your next clinical appointment.
- Dental Worksheet - Dietary changes, lifestyle changes and treatments focusing on improving your dental care.
- For Dentists - Bring this information to your dentist to inform them of Parkinson’s-specific issues, communication tips, medication interactions, DBS information and treatment tips.