HIV i-Base

Adherence support chart and side effects diary

Adherence support chart and side effects diary PDF

Double-sided adherence and side effects chart

Double-sided sheet for patients to record when they have taken their medication and on the reveres side a side effects diary,

Adherence support chart PDF

Double-sided adherence and side effects chart

Single-sided sheet for patients to record when they have taken their medication to help improve adherence.

Side effects diary PDF

Side effects sheet

Single-sided sheet for patients to use to record any changes in their health that could be related to side effects

These are generic versions of clinic forms developed by i-Base and the Royal Free Centre for HIV Medicine.

Some forms have space for patient stickers and for a hospital or clinic logo to be added to from your own clinic or health Trust.

If you have any difficulty with these forms, or would like help adapting them for your Trust, please contact us.