Fundamental GPMP Documentation - Item 721

GP MANAGEMENT PLAN (MBS ITEM No. 721)
Patient’s Name: John Smith  
Date of Birth: 15/06/1975  
Contact Details: 123 Main Street, Springfield, 555-1234  
Medicare or Private Health Insurance Details: Medicare No. 1234 56789 0  
Details of Patient’s Usual GP:  
Dr. Emily Johnson  
456 Health Avenue, Springfield  
555-6789  
Details of Patient’s Carer (if applicable):  
N/A  
Date of last Care Plan/GP Management Plan (if done): 01/05/2024  
Other notes or comments relevant to the patient’s management plan: Patient is motivated to improve lifestyle and manage diabetes effectively.  
PAST MEDICAL HISTORY:  
Type 2 Diabetes, Hypertension, Hyperlipidemia  
FAMILY HISTORY:  
Father had Type 2 Diabetes, Mother had Hypertension  
MEDICATIONS:  
Metformin 500mg twice daily, Lisinopril 10mg once daily, Atorvastatin 20mg once daily  
ALLERGIES:  
Penicillin  
GP MANAGEMENT PLAN:  
Patient problems / needs / relevant conditions: Management of Type 2 Diabetes and Hypertension  
Goals - changes to be achieved: Achieve HbA1c below 7%, maintain blood pressure below 130/80 mmHg  
Required treatments and services including patient actions: Continue current medications, attend diabetes education sessions, follow a low-carb diet, exercise 30 minutes daily  
Arrangements for treatments/services (when, who, and contact details):  
Diabetes education session on 15/11/2024 with Nurse Jane Doe, contact 555-9876  
Copy of GP Management Plan offered to patient? Yes  
Copy / relevant parts of the GP Management Plan supplied to other providers? Yes  
GP Management Plan added to the patient’s records? Yes  
Date service was completed: 01/11/2024  
Proposed Review Date: 01/05/2025  
I have explained the steps and any costs involved, and the patient has agreed to proceed with the plan.  
GP’s Signature: Dr. Emily Johnson  
Date: 01/11/2024