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pdf2018 Monthly Planner
2018 Monthly Planner
This monthly planner is provided as a convenient way to keep track of health care events for
your family. These events will be asked about during the MEPS interview.
Use it to make notes about all types of
health care events:
V
isits to a doctor, dentist, or other health care
provider such as a physical therapist,
chiropractor, or optometrist
n Visits to a clinic or HMO
n Hospital stays
n Visits to an emergency room
n Visits to an outpatient department of a hospital
n Visits for blood tests, X-rays, or other tests
n T
elephone calls to obtain test results or
medical advice
n Admissions to a nursing home
n
Care received at home from a home health care
provider, doctor, nurse, or other health care person
n
Prescriptions for medicines that were filled
or refilled
n
Also record other medical expenses:
n
n
n
n
Eyeglasses or contact lenses
Diabetic equipment and supplies, including insulin
Ambulance services
Crutches, wheelchairs, and other
health-related equipment
For each event, note:
n
n
n
n
The date
The name of the provider
The reason for the visit or medical expense
Charges and payments
2017
January 2017
February 2017
Su
M
Tu
W
Th
F
Sa
1
2
3
4
5
6
7
8
9
10
11
12
13
14
5
6
15
16
17
18
19
20
21
12
22
23
24
25
26
27
28
29
30
31
July 2017
Su
M
Tu
Su
M
Tu
March 2017
W
Th
F
Sa
1
2
3
4
7
8
9
10
11
5
6
13
14
15
16
17
18
12
19
20
21
22
23
24
25
26
27
28
August 2017
W
Th
F
Sa
Su
M
1
Su
M
Tu
April 2017
W
Th
F
Sa
1
2
3
4
7
8
9
10
11
2
3
4
5
6
7
8
13
14
15
16
17
18
9
10
11
12
13
14
19
20
21
22
23
24
25
16
17
18
19
20
26
27
28
29
30
31
23
24
30
25
26
27
September 2017
Tu
W
Th
F
Sa
1
2
3
4
5
Su
M
Tu
W
Su
M
Tu
May 2017
W
Th
F
Sa
M
Tu
W
Th
F
Sa
1
2
3
4
5
6
7
8
9
10
11
12
13
4
5
6
15
14
15
16
17
18
19
20
11
12
21
22
21
22
23
24
25
26
27
18
28
29
28
29
30
31
25
1
October 2017
Th
Su
June 2017
November 2017
F
Sa
Su
M
Tu
W
Th
F
Sa
1
2
1
2
3
4
5
6
7
Su
M
Tu
Su
M
Tu
W
Th
F
Sa
1
2
3
7
8
9
10
13
14
15
16
17
19
20
21
22
23
24
26
27
28
29
30
Th
F
Sa
1
2
December 2017
W
Th
F
Sa
1
2
3
4
Su
M
Tu
W
2
3
4
5
6
7
8
6
7
8
9
10
11
12
3
4
5
6
7
8
9
8
9
10
11
12
13
14
5
6
7
8
9
10
11
3
4
5
6
7
8
9
9
10
11
12
13
14
15
13
14
15
16
17
18
19
10
11
12
13
14
15
16
15
16
17
18
19
20
21
12
13
14
15
16
17
18
10
11
12
13
14
15
16
16
17
18
19
20
21
22
20
21
22
23
24
25
26
17
18
19
20
21
22
23
22
23
24
25
26
27
28
19
20
21
22
23
24
25
17
18
19
20
21
22
23
23 24
25
30 31
26
27
28
29
27
28
29
30
31
24
25
26
27
28
29
30
29
30
31
26
27
28
29
30
24
25
31
26
27
28
29
30
W
Th
F
Sa
Su
M
Tu
W
Th
F
Sa
Tu
W
Th
F
Sa
W
Th
1
2
3
1
2
3
4
5
6
7
1
2
3
4
5
2018
January 2018
Su
February 2018
M
Tu
W
Th
F
Sa
1
2
3
4
5
6
7
8
9
10
11
12
13
4
5
6
14
15
16
17
18
19
20
11
12
21
22
23
24
25
26
27
18
28
29
30
31
25
July 2018
Su
M
2
3
7
8
9
10
4
5
6
7
8
9
10
8
9
10
11
12
13
14
6
7
8
9
10
11
12
3
4
5
6
13
14
15
16
17
11
12
13
14
15
16
17
15
16
17
18
19
20
21
13
14
15
16
17
18
19
10
11
12
19
20
21
22
23
24
18
19
20
21
22
23
24
22
23
24
25
26
27
28
20
21
22
23
24
25
26
17
18
26
27
28
25
26
27
28
29
30
31
29
30
27
28
29
30
31
24
25
Tu
W
Th
F
Sa
2
3
4
5
6
7
8
9
10
11
12
13
14
5
6
15
16
17
18
19
20
21
12
22
23
24
25
26
27
28
19
31
Su
26
M
September 2018
Th
F
Sa
1
2
3
4
7
8
9
10
11
2
3
4
5
6
7
8
13
14
15
16
17
18
9
10
11
12
13
14
20
21
22
23
24
25
16
17
18
19
20
21
28
29
30
31
Su
M
Tu
W
October 2018
W
27
Tu
Tu
Th
F
Sa
Su
25
26
27
28
M
November 2018
M
Tu
W
Th
F
Sa
1
2
3
4
5
6
7
8
9
10
11
12
13
4
5
6
15
14
15
16
17
18
19
20
11
12
22
21
22
23
24
25
26
27
18
19
1
23
24
30
Su
June 2018
1
M
M
May 2018
Sa
August 2018
Su
April 2018
F
1
30
W
March 2018
Th
Su
29
Tu
29
28
29
30
31
Su
25
M
26
Tu
M
Tu
F
Sa
1
2
7
8
9
13
14
15
16
19
20
21
22
23
26
27
28
29
30
Th
F
Sa
December 2018
Th
F
Sa
1
2
3
7
8
9
10
2
3
4
5
6
7
8
13
14
15
16
17
9
10
11
12
13
14
15
20
21
22
23
24
16
17
18
19
20
21
22
23 24
25
30 31
26
27
28
29
27
W
Su
28
29
30
Su
M
Tu
W
1
January 2018
Sunday
Monday
Tuesday
1
Wednesday
Thursday
Friday
Saturday
2
3
4
5
6
New Year’s Day
7
8
9
10
11
12
13
14
15
16
17
18
19
20
25
26
27
Martin Luther King, Jr. Day
21
22
23
24
28
29
30
31
February 2018
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
Valentine’s Day
18
19
20
21
27
28
Presidents Day
25
26
Chinese New Year
22
23
24
March 2018
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
Daylight Saving Time begins
18
St. Patrick’s Day
19
20
21
22
23
24
28
29
30
31
First day of Spring
25
26
27
Good Friday
First day of Passover
April 2018
Sunday
Monday
1
Tuesday
Wednesday
Thursday
Friday
Saturday
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
Easter
Earth Day
29
30
May 2018
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
25
26
Mother’s Day
Ramadan begins
20
21
22
23
24
27
28
29
30
31
Memorial Day
June 2018
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
22
23
29
30
Flag Day
17
18
19
20
Father’s Day
24
21
First day of Summer
25
26
27
28
July 2018
Sunday
Monday
1
Tuesday
2
Wednesday
3
Thursday
4
Friday
Saturday
5
6
7
Independence Day
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
August 2018
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
September 2018
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
1
2
3
4
5
6
7
8
11
12
13
14
15
18
19
20
21
22
Labor Day
9
10
Rosh Hashanah
16
17
First day of Fall
Yom Kippur
23
24
30
25
26
27
28
29
October 2018
Sunday
Monday
7
Tuesday
Wednesday
Thursday
Friday
Saturday
1
2
3
4
5
6
8
9
10
11
12
13
Columbus Day
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Halloween
November 2018
Sunday
Monday
4
Tuesday
Wednesday
Thursday
Friday
Saturday
1
2
3
5
6
7
8
9
10
12
13
14
15
16
17
19
20
21
22
23
24
Daylight Saving Time ends
11
Veterans Day
18
Thanksgiving
25
26
27
28
29
30
December 2018
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
1
2
3
4
5
6
7
8
First day of Hanukkah
9
10
11
12
13
14
15
16
17
18
19
20
21
22
First day of Winter
23
24
30
25
31
Christmas Day
26
First day of Kwanzaa
27
28
29
January 2019
Sunday
Monday
Tuesday
Wednesday
1
Thursday
Friday
Saturday
2
3
4
5
New Year’s Day
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
29
30
31
Martin Luther King, Jr. Day
27
28
February 2019
Sunday
Monday
3
Tuesday
4
Wednesday
5
Thursday
Friday
Saturday
1
2
6
7
8
9
13
14
15
16
22
23
Chinese New Year
10
11
12
Valentine’s Day
17
18
19
20
21
26
27
28
Presidents Day
24
25
March 2019
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
18
19
20
21
22
23
28
29
30
Daylight Saving Time begins
17
St. Patrick’s Day
24
First day of Spring
25
31
26
27
Important Dates
Phone Numbers
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Notes
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2019
January 2019
Su
M
February 2019
Tu
W
Th
F
Sa
1
2
3
4
5
Su
M
Tu
W
March 2019
Th
F
Sa
1
2
Su
M
Tu
April 2019
W
Th
F
Sa
1
2
Su
May 2019
M
Tu
W
Th
F
Sa
1
2
3
4
5
6
Su
M
Tu
June 2019
W
Th
F
Sa
1
2
3
4
Su
M
Tu
W
Th
F
Sa
1
6
7
8
9
10
11
12
3
4
5
6
7
8
9
3
4
5
6
7
8
9
7
8
9
10
11
12
13
5
6
7
8
9
10
11
2
3
4
5
6
7
8
13
14
15
16
17
18
19
10
11
12
13
14
15
16
10
11
12
13
14
15
16
14
15
16
17
18
19
20
12
13
14
15
16
17
18
9
10
11
12
13
14
15
20
21
22
23
24
25
26
17
18
19
20
21
22
23
17
18
19
20
21
22
23
21
22
23
24
25
26
27
19
20
21
22
23
24
25
16
17
18
19
20
21
22
27
28
29
30
31
24
25
26
27
28
24
25
31
26
27
28
29
30
28
29
30
26
27
28
29
30
31
23
24
30
25
26
27
28
29
July 2019
Su
August 2019
M
Tu
W
Th
F
Sa
1
2
3
4
5
6
Su
M
Tu
7
8
9
10
11
12
13
4
5
6
14
15
16
17
18
19
20
11
12
21
22
23
24
25
26
27
18
28
29
30
31
25
September 2019
W
October 2019
Th
F
Sa
Su
M
Tu
W
Th
F
Sa
1
2
3
1
2
3
4
5
6
7
Su
7
8
9
10
8
9
10
11
12
13
14
6
13
14
15
16
17
15
16
17
18
19
20
21
19
20
21
22
23
24
22
23
24
25
26
27
28
26
27
28
29
30
31
29
30
M
November 2019
Tu
W
Th
F
Sa
1
2
3
4
5
Su
M
Tu
W
7
8
9
10
11
12
3
4
5
6
13
14
15
16
17
18
19
10
11
12
20
21
22
23
24
25
26
17
18
27
28
29
30
31
24
25
December 2019
Th
F
Sa
Su
M
Tu
W
Th
F
Sa
1
2
1
2
3
4
5
6
7
7
8
9
8
9
10
11
12
13
14
13
14
15
16
15
16
17
18
19
20
21
19
20
21
22
23
22
23
24
25
26
27
28
26
27
28
29
30
29
30
31
50308.0917
OMB #0935-0118
18-102
| File Type | application/pdf |
| File Modified | 2018-02-21 |
| File Created | 2017-10-02 |