Monitor Your Skin Health and Sun Protection Habits
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Name: _________________ Date Started: //___
Track your sun protection practices by checking boxes:
Record time spent in sun between 10 AM - 4 PM:
Week 1: ____ hours Week 2: ____ hours Week 3: ____ hours Week 4: ____ hours
Date performed: //___
Mark any concerning changes using the ABCDE rule:
Location of changes: ____________________
Last exam date: //___ Next exam due: //___
Review with healthcare provider every: ________
Keep this chart updated monthly and bring to all dermatology appointments
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