The FIRM Guide

The Health and Medical Module

A working medical record — medications, allergies, conditions, providers, insurance, advance directives, and HIPAA authorizations — plus an emergency-ready Family Guide.

Where this Module fits

A-06 Module 6 of 8 in the At-Home area — step 2 of 4 on the dependency ladder (System → At-Home → Financial → Estate).

The working medical record — and the emergency sheet your family hopes never to need.

Adds to The Secure Guide: Working medical record — meds, providers, insurance, directives, HIPAA releases.

Adds to The Family Guide: The emergency sheet — PCP, hospital, allergies, insurance, directive location.

Every Module adds one section to each guide — that is how the two guides assemble as you work. See what you're building.

Download Text File Nothing is entered on this page — you fill the template in privately.

Text file — the flexible one. Use it as-is, paste it into a spreadsheet, open it in any editor, or paste it into an AI tool to reshape the blank form to fit your family: rename a field, add a row, drop one you don't need.

Print / PDF — the ready-to-use one. Print it and fill it in by hand, or choose Save as PDF and complete it in your own offline PDF app. Either way it stays with you — the finished Secure Guide template goes inside your Vault.

One rule: only ever give an AI tool the blank template. Never paste your real information — passwords, account numbers, anything you'd keep secret — into an AI tool, an online service, or anywhere outside your own Vault. Customizing an empty form is fine; filling it in happens privately, offline. That's the same rule this site follows: nothing sensitive ever leaves your hands.

Secure Guide Starter Template — Health and Medical

Store this inside your Vault. One entry per person where the records differ — “the family” works for a shared entry with per-person rows. Keep each section current. Children's records belong here too — and as they reach adulthood, they build their own, including their own HIPAA authorizations.

One problem in this Module most families don't know they have: federal privacy law restricts who may receive your medical information — including your spouse and adult children — unless you've authorized it in writing, in advance, with each provider individually. No paperwork means no access, regardless of the relationship. The HIPAA table below is where you close that gap, provider by provider. And permission to start small: a usable record beats a perfect one — most of this page is two hours on a Saturday.

Whose record this is — a name, or “the family” for a shared entry with per-person rows in the tables below.
Medications
NameDosageFrequencyPrescribing ProviderPharmacy

One page, kept current — and a photo of it on your phone.

Known Allergies
SubstanceReaction
Chronic Conditions / Ongoing Care
ConditionManaging ProviderNotes
Medical Providers
RoleNamePracticePhonePatient Portal

Patient portal credentials are stored in The Vault.

Health Insurance
TypeCarrierPlan NameMember IDGroup #Member Services

Insurance portal credentials are stored in The Vault.

Advance Directives
DocumentDate ExecutedStorage LocationWho Has Copies

See the Estate Plan Module for formal legal context — but the documents must be findable here, in a medical emergency, not only in the estate file.

HIPAA Release Authorizations
Authorized PersonRelationshipOn File WithDate Authorized

Each provider keeps its own form, and authorizations do not transfer between health systems — re-sign when you move or change providers. Minutes per provider; it closes the most preventable access failure in a medical emergency.

Family Medical History (optional)
ConditionAffected RelativeApprox. Age of Onset

Practical, not genealogical — what your providers and heirs may need for informed medical decisions. The family story — and where the family-tree research lives — is the Family Compass Module's territory.

Date of the most recent review.
Health and Medical; secure-guide; family-guide; At-Home

Family Guide Starter Template — Health and Medical

For use by family members, caregivers, or first responders — deliberately the richest Family Guide section in the system, because in a medical emergency this is the page your family opens first. It contains no sensitive credentials — and any information that would be useful to have immediately, and meets your privacy and security preferences, can go here.

In the matching Secure Guide section: working medical record — meds, providers, insurance, directives, HIPAA releases.

That detail is what makes recovery possible — and it is protected in the Vault, which opens with The Vault Key. The key is never written here, by design. The people listed on this page know how it is kept, and the steward's job is to keep that path current, so this page never leads to a locked door.

A name, or “the family” — most households keep one shared emergency sheet; print per-person pages where care differs.
Name — the first call that isn't 911.
Primary care physician's phone.
Where to go, and where the records already are.
The critical ones, per family member — the line a first responder reads.
See the Secure Guide, or attach the printed one-page list.
Health insurance carrier.
Insurance member-services line.
Where the card is kept.
Advance directives — location.
Who is authorized to decide.
How to reach that person.
Pharmacy name.
Pharmacy phone.
Pharmacy address.
The lock-screen emergency info first responders can read without unlocking — set it on each family phone. The highest-return five minutes in this Module.

Any context relevant to emergencies or ongoing care.

If a call or message asks the family to “confirm” health details, insurance numbers, or portal access — however much it already seems to know — call the provider back on the number on this page, never the number in the message. This page is the family's known-good callback sheet.

Anything this page's reader should know that the sections above didn't ask for — the exceptions, the house quirks, the thing you would say out loud while handing this page over.

Worked example — Frank's family

Frank's annual checkup came back with his first take-it-indefinitely prescription: blood pressure, plus a statin and a standing cardiology referral. That evening Sarah asked if she should know his medications. Sure, he said — check the MyChart app. She asked for the password. He couldn't remember which email he'd even registered with. The record below took two hours on a Saturday. It isn't perfect; it's usable.

All details are fictional and illustrative. The assembled example guides live at the example Secure Guide and the example Family Guide.

Secure Guide — Frank's entry

The Health and Medical section of Frank's encrypted Secure Guide volume — one record for the household, last reviewed 2026-04:

The family — one shared entry; every table below carries per-person rows
Medications
NameDosageFrequencyPrescribing ProviderPharmacy
Lisinopril (Frank)10 mgDaily, morningDr. Anita Rao — Westvale Family PracticeMain Street Pharmacy
Atorvastatin (Frank)20 mgNightlyDr. Anita Rao — Westvale Family PracticeMain Street Pharmacy

The one-page list is printed for the binder and photographed on Frank's and Sarah's phones.

Known Allergies
SubstanceReaction
Penicillin (Jacob)Rash — childhood reaction, on file with Westvale Pediatrics
None known (Frank, Sarah, Lily)Recorded as “none known” so nobody has to wonder
Chronic Conditions / Ongoing Care
ConditionManaging ProviderNotes
Elevated blood pressure (Frank)Dr. Anita RaoStanding cardiology referral — first visit scheduled
Cholesterol (Frank)Dr. Anita RaoStatin — see Medications
Medical Providers
RoleNamePracticePhonePatient Portal
Primary care (adults)Dr. Anita RaoWestvale Family Practice555-0122MyChart — credentials in the Vault (found after a hunt for the registration email; see Identities)
Cardiologist (referral)Dr. Paul EganWestvale Cardiology Group555-0183Portal signup at first visit
Pediatric / teen careDr. Maya ChenWestvale Pediatrics555-0166Parent-proxy portal — both parents
Health Insurance
TypeCarrierPlan NameMember IDGroup #Member Services
Medical (family)Cornerstone Health (via Meridian Logistics — see Work History)Cornerstone Choice PPOCHF-88214-07 (card scan in the Vault)GRP-4415555-0149 (also in the Family Guide)
Dental (family)Cornerstone DentalChoice DentalCHD-88214-07GRP-4415555-0149
Advance Directives
DocumentDate ExecutedStorage LocationWho Has Copies
Living will (Frank)2023Fire safe, home officeSarah (location confirmed 2026-04 — she didn't know until asked) + Ruth Alvarez, the estate attorney
Healthcare proxy (Frank → Sarah)2023Fire safe, home officeSarah + Ruth Alvarez
HIPAA Release Authorizations
Authorized PersonRelationshipOn File WithDate Authorized
SarahSpouseWestvale Family Practice2026-04 — five minutes at the front desk
SarahSpouseWestvale Cardiology GroupFLAGGED — sign at the first visit; authorizations don't transfer between systems
Frank + SarahParentsWestvale PediatricsOn file since enrollment
Family Medical History
ConditionAffected RelativeApprox. Age of Onset
Heart diseaseFrank's father60s — part of why the cardiology referral gets kept, not postponed

Family Guide — Frank's entry

The emergency sheet — the first page behind the At-Home tab of the household binder, and the page the family opens first.

The Mercer family — one shared emergency sheet, posted where everyone knows it lives
Dr. Anita Rao, Westvale Family Practice — 555-0122
Westvale Regional Medical Center — fifteen minutes away, and where Dr. Rao's records already are
Jacob: PENICILLIN. Frank, Sarah, Lily: none known
Frank takes two daily prescriptions — the printed list is clipped behind this page; photo on Sarah's phone
Cornerstone Choice PPO — member services 555-0149; cards in wallets, scan in the Vault
Living will + healthcare proxy: fire safe, home office. Decision-maker: Sarah
Main Street Pharmacy — 555-0134, 214 Main Street
Set on all four phones 2026-04 — allergies, meds, and emergency contacts readable from the lock screen

House rule: any call or message asking to “confirm” health details, insurance numbers, or portal access gets a callback on the provider number on THIS page — never the number in the message. However much the caller already knows.