eDsign Service

info-init®, Inc.

Publisher of educational CDROMs. A new business venture we started and managed for 5-years.

What we did:

• Project Concept
• Writing
• Design + production
• CDROM production
• Print management
• Marketing & PR

The info-init® CDROM core product is a customizable documentation system comprised of many forms (in addition to vast educational resources). Forms included with Health: info-init® and Computer: info-init® are listed below.

Health: info-init® Form Index

70 Health forms are organized into 10 categories. Click a category below to see a list of it's forms.

NOTE: Some forms are available as downloads.

1. HEALTH HISTORY Use the forms in this category to develop a comprehensive personal health history record.
2. MEDICATION Use the forms in this category to document information that can help ensure proper medication dosing, prevent or minimize side effects and avoid negative drug interactions.
3. CONDITION Use the forms in this category to manage information associated with the diagnosis and treatment of a health condition.
4. PREVENTIVE CARE Use the forms in this category to help develop and track a preventive health care plan. Improve your chances for a long and healthy life by working with your doctors to develop a preventive care schedule. TIP: The Bonus Package on the Health: info-init® CD also has several forms related to preventive care, including "Emergency Medical Information ID" wallet cards.
5. PREGNANCY Use the forms in this category to manage information about your pregnancy.
6. CHILDHOOD Use the forms in this category to track and manage information about your child's health and development.
7. INSURANCE Use the forms in this category to help you better understand your health insurance policy. Forms are included to help you evaluate and compare health insurance options and choose the best quality coverage for the lowest cost.
8. BILLING Use the forms in this category to help you keep track of all your medical expenses. Good recordkeeping helps avoid surprises and prevent confusion when your health care bills arrive.
9. LONG-TERM CARE Use the forms in this category to help you understand and evaluate long-term care needs and service options.
10. END-OF-LIFE Use the forms in this category to prepare for end-of-life issues. Being prepared can help you and your loved ones through this challenging and often difficult transition.

HEALTH HISTORY forms

Personal Information

Use this form for basic information about yourself. Includes contact, identification, insurance and advance directive information.

Checklist

Use this form to provide you and your doctor with a quick overview of your medical history. NOTE: This is a 2-page form.
 Checklist (.zip)

Birth / Congenital / Blood / Childhood

Use this form to document basic information about your birth, your mother's health at the time of your birth, your blood type, and your childhood disease history.

Allergies

Use this form for information about any allergies you have. NOTE: This is a multi-page form (print as many second pages as needed).
 Allergies (.zip) 

Dental Work

Use this form to keep a record of any dental work performed.

Pregnancy & Childbirth

If you are a woman who has been pregnant, use this form for information about your pregnancy and birthing history. NOTE: This is a multi-page form (print as many second pages as needed).

Laboratory Tests / Screenings / Imaging

Use this form to document information about important or significant lab tests, x-rays and other screenings and imaging procedures you have had.

Lifestyle

Use this form to develop a comprehensive lifestyle history document and identify issues that may affect your health. Lifestyle information can help guide your doctors to better diagnoses and health recommendations. NOTE: This is a 4-page form.
 Lifestyle (.zip)

Family Member

Use this form to gather important medical information about a blood relative. Family medical history information can identify health issues that may have an impact on your genetic risk factors. TIP: If you have trouble filling in information for a relative, contact or send this form to one of your relatives who can help. In return, you can send sets of the completed family history forms to those family members for their own health records.

Family Genogram

Use this form to create a simple diagram that illustrates your genetic heritage. This information may help to identify possible inherited risk factors.

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MEDICATION forms

Current Medications, Supplements & Herbs

Use this form to record information about the medications, supplements, and herbs that you are using: General medication information; Why you are taking the medicine; Dosage and frequency information; Any side effects experienced. NOTE: This is a multi-page form (print as many second pages as needed).
Current Medications, Supplements & Herbs (.zip)

Responsiveness

Use this form to document your responsiveness to medication. Understanding your level of responsiveness can help your doctor in determining proper dosing. Proper dosing can prevent or lessen the severity of medication side effects.

Information

Use this form to document information about a prescribed medication: Dosages; Side effects; Why you are taking the medication; Results experienced.

Schedule

Use this form to list your overall medication schedule. Refer to it daily to reduce confusion and verify when your medications are to be taken.
 Schedule (.zip)

Checklist

Keep track of when a specific medication is to be taken. Verify with a check mark that the medication was indeed taken at the proper time. This helps to prevent missing or repeating medications. NOTE: This form can also be useful in caregiver situations where other people are responsible for administering medications.

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CONDITION forms

Visit Worksheet

Use page one of this form to prepare for a visit with your doctor. Refer to pages two and three of the form during the visit for additional questions to ask your doctor. NOTE: This is a 3-page form.
 Visit Worksheet (.zip)

Diagnosis & Treatment

Work with your doctor to fill in this form to ensure that you understand your diagnosis and treatment plan.

Test / Exam Record

Use this form to keep track of the various test results and exams associated with a single, specific condition or injury.

Emergency Coronary Card

If you have a heart condition, use this form to create a wallet card with emergency treatment information about your condition.
 Emergency Coronary Card (.zip)

Emergency Implant Card

If you have a pacemaker, valve, or implantable cardioverter-defibrillator (ICD) implant, use this form to create a wallet card with emergency treatment information. NOTE: This is a 3-page form. One page for each type of implant.

Hospital Evaluation

Use this form to compare hospitals before you make your selection (one form per facility). Not all hospitals are best for all things, and some hospitals excel in a specific area of treatment. If you are able to choose the hospital you go to, choose the best one for your needs.

Surgery EVALUATION of PROCEDURE

Use this form to help evaluate the risks and benefits of a surgical procedure. Any surgery has risks that should be carefully considered and understood. Examine the need for surgery and your alternatives. NOTE: This is a 2-page form.
 Surgery EVALUATION of PROCEDURE (.zip)

Surgery SERVICES and COSTS

Use this form to compare your surgical options. Surgery is expensive and hospitals, surgeons and surgical services can vary in their quality and costs. Make the best choices for your needs.

Surgery PREPARATION and RECOVERY

Use this form to record the information you need to properly prepare for and recover from your surgery.

Health Equipment

Use this form to keep a record of purchase, warranty and manufacturer information for your medical equipment.

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PREVENTIVE CARE forms

Immunization Record

Use this form to identify important adolescent and adult immunizations, and to document information about the immunizations you receive.

Influenza Immunization Record

Use this form to document when and where you receive your flu shots, and for information about the vaccine lots.

Travel Immunizations / Recommendations

If you are planning travel to a foreign country you may require special immunizations. Consult with your doctor to determine your immunization needs. There also may be additional specific health alerts (e.g., malaria, diarrhea, etc.) as well as safety or security concerns that you need to be aware of. Use this form to document travel health recommendations and your travel immunization information.
 Travel Immunizations / Recommendations (.zip)

Screening Recommendations WOMEN

Consult with your doctor to determine which screenings you should have. Use this form to document your doctor's screening recommendations (for women). NOTE: This is a 2-page form.

Screening Recommendations MEN

Consult with your doctor to determine which screenings you should have. Use this form to document your doctor's screening recommendations (for men). NOTE: This is a 2-page form.

Screening Record

Use this form to record information about a single, specific type of test or exam. NOTE: If you have a condition that requires different types of tests and exams, use the Test/Exam Record form in the Condition category.

Dental Record

Use this form to record information about your dental tests and exams.

Eye Care Record

Use this form to record information about your eye and vision exams.

Practitioner Evaluation

This form provides you with a tool to help evaluate a new practitioner. Determine the best doctor for your needs.
 Practitioner Evaluation (.zip)

Health Care Contacts

Use this form to record detailed contact information for all your health care practitioners and suppliers. NOTE: Four contacts per form. Print pages as needed.

Health Care Contacts INSERTS

Use this form to record contact information for your health care practitioners and suppliers. NOTE: Four contacts per form. Print pages as needed. OPTION: A feature of this Contacts format is that information updates are easier. Use to create inserts for clear plastic 3-ring binder business card holder pages (available at office supply stores).

First Aid Checklist

Use this checklist as a guide for purchasing the supplies needed to put together first aid kits for your home and automobile. The second page of this form has a list for putting together a first aid kit for travel. NOTE: This is a 2-page form.

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PREGNANCY forms

Screening Recommendations

Consult with your doctor to determine which screenings you should have before and during your pregnancy. Use this form to document your doctor's screening recommendations. NOTE: This is a 2-page form.
 Screening Recommendations (.zip)

Prenatal Exam Record

Use this form to keep a record of all your exams before and during your pregnancy. NOTE: This is a multi-page form (print as many second pages as needed).

Labor & Delivery

Use this form to keep a record of labor and birth information. NOTE: This is a multi-page form (print as many second pages as needed).

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CHILDHOOD forms

Screening Recommendations

Consult with your doctor to determine which screenings your child should have. Use this form to document your doctor's screening recommendations. NOTE: This is a 2-page form.
 Screening Recommendations (.zip)

Immunization Record

Use this form to identify childhood immunizations and record information about the immunizations your child receives.
 Immunization Record (.zip)

Growth Record

Use this form to keep a record of your child's growth.

Well Child Exam Record

Use this form to keep a record of your child's wellness exams. NOTE: Two exams per form.

Development

Use this form to document and track your child's physical and psychological development. NOTE: This is a multi-page form. Each page is used during a specific age range (designated at the top of the form). Development checklists are based on statistically typical developmental markers. If you are concerned about your child's development consult with your child's doctor.

Tooth Chart

Use this form to keep a record of when your child's primary teeth come in and fall out, and when permanent teeth come in.
 Tooth Chart (.zip)

Dental Work History

Use this form to document dental work performed on your child's teeth.

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INSURANCE forms

Health Plan

Use this form to document information about your health plan. Understand the requirements, services, benefits, costs and payment policies of your health plan. NOTE: This is a 2-page form.
 Health Plan (.zip)

Original Medicare Plan

Use this form to document information about your Original Medicare Plan. Understand the requirements, services, benefits, costs and payment policies of your Original Medicare Plan. NOTE: This is a 2-page form.

Supplemental Plan

If you have supplemental insurance, use this form to document the type of policy, coverage, costs, and insurance company contact information. NOTE: Use one form for each supplemental insurance plan that you have.

Health Plan Evaluation

Use this form to evaluate a health plan's basic structure and the benefits it offers. NOTE: To compare health plans with each other, fill in one form for each plan that you would like to compare.

Health Plan Evaluation COSTS & SERVICES

Use this form to compare the costs and services of up to three health plans. A side-by-side format makes it easy to evaluate how different plans compare with one another. NOTE: This is a 2-page form.

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BILLING forms

Visit Cost Record

Use this form to: Identify the various bills associated with a visit and verify what they are for; Keep track of all of the costs associated with each visit; Know what your insurance will pay for, and what costs you are responsible for; Identify billing errors. This form also provides a comprehensive record of visit costs. If there are any questions or disputes with your insurance company or service provider, you'll have the information you need to address issues with confidence. TIP: Print a few extra copies of this form to have on hand when needed.
 Visit Cost Record (.zip)

Uninsured ANNUAL MEDICAL PAYMENT RECORD

If you have no health insurance, use this form to track all your annual health care expenses. NOTE: A record of your annual health care costs also is useful when preparing year-end taxes.
 Uninsured ANNUAL MEDICAL PAYMENT RECORD (.zip)

Insured ANNUAL MEDICAL PAYMENT RECORD

If you have health insurance coverage, use this form to track all your annual health care expenses. NOTE: A record of your annual health care costs also is useful when preparing year-end taxes.

Original Medicare Plan ANNUAL MEDICAL PAYMENT RECORD

If you have an Original Medicare Plan, use this form to track all your annual health care expenses. NOTE: A record of your annual health care costs also is useful when preparing year-end taxes.

Medicare and a Medigap Plan ANNUAL MEDICAL PAYMENT RECORD

If you have an Original Medicare Plan and supplemental health insurance, use this form to track all your annual health care expenses. NOTE: A record of your annual health care costs also is useful when preparing year-end taxes.

Annual Prescription Payment Record

Use this form if you want to keep a separate record of your prescription drug costs.

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LONG-TERM CARE forms

Needs Assessment

Use this form to identify long-term care needs. Once needs are clarified, you can determine the type of care or service that will best meet these needs. NOTE: This is a 2-page form.
 Needs Assessment (.zip)

Cost Comparison

Use this form to evaluate how you will pay for long-term care, and to compare the costs of up to three different types of long-term care services.

In-Home Care Provider Evaluation

Use this form to evaluate an in-home care service provider. NOTE: To compare in-home care providers, fill in one form for each provider that you would like to compare. This is a 2-page form.

Assisted Living or CCRC Evaluation

Use this form to evaluate an assisted living facility or a Continuing Care Retirement Community (CCRC). NOTE: To compare assisted living facilities or CCRCs, fill in one form for each facility that you would like to compare. This is a 3-page form.

Nursing Home Evaluation

Use this form to evaluate a nursing home. NOTE: To compare facilities, fill in one form for each facility that you would like to compare. This is a 3-page form.

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END-OF-LIFE forms

Funeral Preferences

Use this form to help ensure that your funeral is carried out according to your wishes and preferences. NOTE: This is a 3-page form.
 Funeral Preferences (.zip)

Funeral Checklist

Use this checklist to help guide those responsible for managing your funeral arrangements through the challenging and often complex issues involved.

Last Wishes

Use this form to communicate your desires for your last days: End-of-life care; How you would like to be remembered; Your spiritual values; Parting thoughts and messages.
 Last Wishes (.zip)

Legal Documents

Use this form to summarize important legal information and direct those responsible to the location of the original documents. Ensure that your preferences are known and your wishes are followed.

Financial Information

Use this form to make a comprehensive list of your accounts, locations, and other important financial information. NOTE: This is a 5-page form.

Memberships

Use this form to make a list of any membership benefits your survivors are eligible for, and the organizations that should be notified at the time of your death.

Contacts

Use this form to make a list of the people whom you would like to be informed of your death.

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Computer: info-init® Form Index

33 Computer forms are organized into 7 categories. Click a category name to see a list of it's forms.

NOTE: Some forms are available as downloads.

1. INTERNET Use Internet forms to document the information that enables you to connect to and use the Internet. Includes email forms.
2. HARDWARE The forms in this category are used for information about your computer, internal and external hardware.
3. SOFTWARE The forms in this category are used to document information about the software installed on your computer.
4. SYSADMIN The forms in this category help you keep your computers running smoothly.
5. BACKUP & RECOVERY The forms in this category are used to develop and manage a backup plan to ensure that your critical data is protected.
6. NETWORK Local Area Networks (LANs) come in all shapes and sizes. Use network documentation tools to analyze your needs, set up, manage, and maintain your network.
7. EVALUATION With so many choices and options, deciding which new computer to buy can be complicated. Use the evaluation forms to guide you through the decision-making process. Find the right computer for your needs at the best price.

INTERNET forms

ISP / Connection

Use this form when setting up an account with an Internet Service Provider (ISP). A record of your connection settings is useful should you need to re-configure your connection at a later date.
 ISP / Connection (.zip)

Email

Use this form to keep track of multiple email accounts.
 eMail (.zip)

Passwords

Use this form to keep track of your passwords and access information for website memberships.

Research

Use this form as a to-do list and to write down ideas you would like to explore further. When online, your research will be more focused and productive.

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HARDWARE forms

Computer

Use this form when you purchase a new computer or upgrade your existing computer.

Component

Use this form for information about internal hardware upgrades or replacements, and for external hardware peripherals.
 Component (.zip)

Cable Label

Use cable labels to ensure that connections are made correctly. Cable labels also are useful when systems are moved from one location to another.

Component List

This form lists your computer's internal hardware upgrades and external peripherals. Refer to it when preparing to set up or rebuild your computer, and when creating tab inserts for your binder. TIP: When upgrading operating system (OS) software, use this form to verify that you have all necessary hardware "drivers" or "control panels" and that they are compatible with the new OS.

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SOFTWARE forms

Operating System (OS)

Use this form when installing or upgrading operating system software.

Application

Use this form when installing, upgrading and troubleshooting software. Use one form for each software application.
 Application (.zip)

User Notes

Use this form to document software settings, a new technique or a work-around for a problem. File the completed form in the appropriate section of your binder. NOTE: This form also is useful for hardware products. TIP: Print a few extra forms to have on hand when you need them.

Application List

This form lists the software installed on your computer. Refer to it when preparing to set up or rebuild your computer, and when creating tab inserts for your binder. TIP: When upgrading operating system (OS) software, use this form to verify that the software application versions you have are compatible with the new OS.

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SYSADMIN forms

Maintenance Record

Routine maintenance is a simple way to prevent common problems. Use this form to keep track of maintenance that has been performed on your computer.

Troubleshooting Report

Use this form to track the process of isolating a problem. File the completed form in the appropriate section of your binder. NOTE: There is a second page to this form that can be used if you need more space.

Computer Setup/Rebuild Checklist

Use this form as a step-by-step checklist to guide you through the process of setting up or rebuilding your computer system.

 Computer Setup/Rebuild Checklist (.zip)

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BACKUP & RECOVERY forms

Backup & Recovery Guide

The BACKUP & RECOVERY Guide is an introduction to concepts and issues that need to be addressed in backup and recovery planning. NOTE: This is an 11-page form.
 Backup & Recovery Guide(.zip)

Backup Plan

Use this form to develop and document a comprehensive, company-wide backup and recovery plan. This 5-page form documents backup plan details, including: administration responsibilities; hardware and software infrastructure; step-by-step backup and recovery procedures; data protection checklist to evaluate your plan.

Data to Back Up

Use this form to identify specific data requiring backup protection.

Rotation Schedule

Use this form to document your backup-set media rotation schedule. Use one form for each computer or group of computers.

Backup Job Log

Use this form to track and verify backup job statistics and performance.

Storage / Archive Record

Use this form to maintain a record of your backup media stored at a secure off-site facility.

Media Labels

Use this form to create labels for backup media containers. Print labels on heavy-weight paper. TIP: Use different colors of paper to coordinate media containers with the backup rotation schedule. Media labels for the following products are included: 4mm DDS Tape, 8mm Tape, Travan, DLTtape®, CD / DVD Jewel Case front cover insert, CD / DVD Jewel Case back cover insert. (Note: This FREE download is for CD / DVD Jewel case only.)
 Media Labels (.zip)

Setup

This form provides step-by-step instructions for setting up a backup binder. Depending on your needs, BACKUP & RECOVERY forms can be used in any number of ways. Two typical backup binder examples are described, one for a single computer user and one for a small business.

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NETWORK forms

Analysis

Use this form for planning a new network or a network extension. The completed form provides a guide for network design, installation, implementation and upgrades. NOTE: The instructions for this form provide terminology definitions and information on a variety of networking issues.
 Analysis (.zip)

Diagram

Use this form to sketch your planned or existing network. Include all network devices: hub, switch, modem, printer, server, client computers, etc. Also create a diagram of the structured cable installation (network infrastructure). Refer to the cable installation diagram when troubleshooting cable-related problems. Revise the cable installation diagram whenever the network is modified.

Cable Label

Cable labels will help you troubleshoot cable-related problems quickly and accurately. It is estimated that 70% of network infrastructure problems are cable-related.
Node Connections: (Server, client computer, printer, modem, etc.) Cable labels ensure that connections are made correctly when setting up your network, adding nodes, or when nodes are moved from one location to another.
Structured Cabling: Use cable labels when installing network cabling infrastructure.

User / Client Computer

Use this form to keep track of network user information and/or client computer information, depending on how your network is set up.

Equipment Inventory

Use this form to list the equipment connected to your network. If you are setting up a new network, list the equipment you plan to connect. In addition to providing a record of your network equipment, this list can identify equipment needs and indicate when existing equipment is due for replacement.

Printer Maintenance

Use this form to document printer service and maintenance. Include a brief description of work performed and costs for labor, parts and consumables.

Troubleshooting

Use this form to document network troubleshooting efforts and results. While network technical problems can be complex, network professionals estimate that as much as 70% of the problems they encounter with networks are infrastructure-related. NOTE: A basic infrastructure checklist is provided on the lower part of the form.

Setup

This form provides step-by-step instructions for setting up a network binder. Depending on your needs, NETWORK forms can be used in any number of ways. Two typical examples are described, a home network and a small business network.

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EVALUATION forms

Pre-Purchase

Use this form to identify the product features important to you. The more knowledge you have, your chances will be better that you will purchase the right computer at the best price. NOTE: This is a 3-page form.
 Pre-Purchase (.zip)

Product Comparison

Use this form for a side-by-side comparison of two computers. The better you understand your choices, the more confident you'll be in your purchase decision.

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