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Osteoporosis Monitoring Chart

Track Your Bone Health Progress

Endocrinology

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Template Content

Last updated: Mar 24, 2025

Patient Information

Name: _________________ Date of Birth: _________ Medical Record #: ________

Bone Mineral Density (BMD) Results

DXA Scan History

Date T-Score Hip T-Score Spine T-Score Wrist

Risk Factors Checklist

  • Family history of osteoporosis
  • Early menopause
  • Smoking status
  • Low calcium intake
  • Limited physical activity
  • Corticosteroid use

Medication Tracking

Current Osteoporosis Medications

Medication: _________________ Dosage: ____________________ Start Date: ________________

Supplements

  • Calcium: ______mg/day
  • Vitamin D: ______IU/day

Lifestyle Modifications

Exercise Log

  • Weight-bearing exercises: ____ minutes/week
  • Resistance training: ____ sessions/week

Fall Risk Assessment

  • Balance issues
  • Vision problems
  • Home safety evaluation

Notes

Next appointment: ________________ Special instructions: _____________

Please bring this chart to each appointment

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