Appointment Worksheet

For your convenience, I have created two appointment worksheets which you can download. If you ask anyone in the medical profession "what is the one thing you should do to prepare for your appointment" they would all say "write it down!!!!" Write down your questions and the responses!!! Don’t feel like you are pressured to hurry and write. Make sure you have got it all down so that you will understand it when you are at home reviewing your notes.

From this very second until the time of your next appointment, you will want to write down any questions, comments or concerns regarding your heath condition including questions about medications or when/if you should undergo diagnostic procedures such as mammography, cardiac treadmill, bone density and so on.

Things have become too fast paced and stressful, making it difficult for you to remember things from one moment to the next let alone a question you may have for your doctor three to six months down the road.

An appointment worksheet can help.

My husband and I make a practice of carrying a small notebook to jot things down while they are fresh in our mind. Once we are at the doctor's we make sure that each question/concern is addressed by writing the response next to the question.

You can use either the Doctor Appointment Worksheet or Appointment Notes sheet as guidelines in making your own form or you can simply download the forms as is. After your doctor appointment, you can keep your notes in your medical information binder as a sort of a reference.

We have a binder and a thumb drive of all our medical records. We live in the land of earthquakes, and fires. We have to be ready at a moment's notice to evacuate. Our medical records are the second thing (after our dogs) that we take with us!

Your physician will want to confirm your current medications. For this reason, I have given you a space to write out your medications prior to your doctor appointment. Be sure to include the dose and how often you are taking each medication. The "memos" section will allow you to jot a note to yourself regarding possible tests you will need. For example, you may want to jot down when you will have to schedule your yearly eye exam or next cardiac treadmill.

Remember, the tool (appointment worksheet or appointment notes forms) is only as good as its user. Whether you use the forms as is or you make your own form doesn't really matter as long as you make it work for you!!! I don't care how you do it or what it looks like, just be sure you write it down!!!!


DOCTOR APPOINTMENT WORKSHEET

Doctor's Name:________________________________________________________

Previous Appointment___________________________ Next Appointment_________________________

Routine________ Emergency_______ Follow-up_______

QUESTIONS:

  1. ________________________________________________________________________________________

    ________________________________________________________________________________________

  2. ________________________________________________________________________________________

    ________________________________________________________________________________________

  3. ________________________________________________________________________________________

    ________________________________________________________________________________________

DOCTOR'S ANSWERS:

  1. ________________________________________________________________________________________

    _________________________________________________________________________________________

  2. ________________________________________________________________________________________

    _________________________________________________________________________________________

  3. ________________________________________________________________________________________

    _________________________________________________________________________________________

CURRENT MEDICATIONS:

_________________________________________________________________________________________

_________________________________________________________________________________________

_________________________________________________________________________________________

MEDICATIONS CHANGED/ADDED
DRUG/DOSE PURPOSE HOW TO TAKE DATE CHANGED
       
       
       
       

MEMOS:

_________________________________________________________________________________________

_________________________________________________________________________________________

_________________________________________________________________________________________

_________________________________________________________________________________________

_________________________________________________________________________________________

You can click here to print out a copy of an appointment worksheet to fill in. Please note, you must have Adobe® Reader® on your computer to view and print these forms. If you do not have this software, and would like a free copy of it, please click

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This form can be kept in your healthcare binder to maintain a more complete record.


A shorter version of this worksheet is shown below.


Appointment Notes

Doctor_______________________________________

Date________________________

Routine Visit_________________

Emergency Visit_______________

Next Appointment__________________________________

Planned Labs/Diagnostic Tests________________________________________________

Follow-up_________________________________________

Changes in Medication____________________________________________________________________

Questions/Notes:____________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

You can click here to print out a copy of a worksheet to fill in.




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