Nhs Colchester Food Record Chart
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1FOOD RECORD CHART
Name: ________________________________
Unit/NHS No: _______________
Texture of Diet ……………………………….
Stage of thickness of fluids ………………………….
Please record all food and drink taken. If food refused, or placed NBM then please indicate
.
this
DATE
BREAKFAST
LUNCH
SUPPER
Food Served
Food Eaten
Food Served
Food Eaten
Food Served
Food Eaten
____/____/____
SNACKS
SUPPLEMENTS
Food Served
Food Eaten
Food Served
Food Eaten
Food Served
Food Eaten
____/____/____
SNACKS
SUPPLEMENTS
Food Served
Food Eaten
Food Served
Food Eaten
Food Served
Food Eaten
____/____/____
SNACKS
SUPPLEMENTS
Food Served
Food Eaten
Example:
E.g Patient ate half of the portion of
2 tablespoons shepherds
3 March
the main course served and a quarter
pie + 1 tablespoon veg
of the portion of the pudding served
1 tablespoon apple crumble and custard
SNACKS
None
SUPPLEMENTS
100mls Fresubin Energy
Page 16
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Parent category: Life