AF IMT Form 2508 "Patient Calorie Count Sheet"

AF IMT Form 2508 or the "Patient Calorie Count Sheet" is a form issued by the U.S. Air Force IMT (Information Management Tool).

Download a PDF version of the AF IMT Form 2508 down below or find it on the U.S. Air Force IMT (Information Management Tool) Forms website.

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Download AF IMT Form 2508 "Patient Calorie Count Sheet"

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PATIENT CALORIE COUNT SHEET
DATE
(SEE INSTRUCTIONS ON REVERSE)
FOOD ITEM
PORTIONS
KCAL
PRO
REMARKS
BREAKFAST
SNACK
LUNCH
SNACK
SUPPER
SNACK
PATIENT IDENTIFICATION
AF IMT 2508, 19840301 V2
PATIENT CALORIE COUNT SHEET
DATE
(SEE INSTRUCTIONS ON REVERSE)
FOOD ITEM
PORTIONS
KCAL
PRO
REMARKS
BREAKFAST
SNACK
LUNCH
SNACK
SUPPER
SNACK
PATIENT IDENTIFICATION
AF IMT 2508, 19840301 V2
INSTRUCTIONS FOR KEEPING CALORIE COUNT
1. For the next three days, write down everything consumed in each 24-hour period.
2. Estimate portion sizes. Example: 1/2 cup of mashed potatoes, 1/2 serving of vegetables, 3/4 piece of cake, etc.
3. Describe food accurately. Example: "Breaded Veal Cutlet", "Roast Beef with Gravy",. "Fried Chicken Leg".
4. Do not forget additional items. Example: margarine, gravy, salad dressing, sugar, cream in coffee.
5. List all beverages correctly. Example: lowfat milk, whole milk, skim milk, kool-aid, pepsi, coffee-black.
6. Do not write in the calorie or protein column.
7. Keep all menus when calorie count has begun and attach them to this sheet with the provided paper clip.
8. The dietitian will collect the menus and calorie counts to determine the caloric intake.
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