Infusion Log

 

Keeping accurate records of infusions, bleeds, and other medications can help identify patterns and help prevent future problems. Completed Infusion Logs provide an accurate measure of your factor usage and can be helpful for insurance issues.

 

Where can I get the Infusion Log

 

Gulf States HTC Infusion Log is available to download and print in a PDF file. [English] // [Spanish]

or you may choose to record your infusions using an electronic log or a different paper log.

 

What Information to put on the Infusion Log

 

The Infusion Log includes space for you to record the date of each treatment, the name, lot number, and expiration date of the product you used, and the amount of factor used. Fill out your infusion log completely.

 

In the box that says Pain Scale, please indicate the level of pain associated with bleed or injury, if any, on a scale of 1 to 10, with 1 being the lowest pain level.

 

Please bring your completed infusion logs to your clinic appointments to review with your clinical team members.

To Schedule An Appointment

Call 713.500.8360​

Gulf States Hemophilia and Thrombophilia Center

6655 Travis St. Houston, TX 77030

 

Copyright 2019 // All Rights Reserved

 

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