Doctor-Visit Organizer
Prepare the most important information and questions before the appointment.
Page 1 of 2 · Before the visit
Main reason for this visit
Changes since the last visit
Symptom timeline
| Symptom or concern | Started | When / how often | What makes it better or worse |
|---|---|---|---|
Medicine concerns
My three most important questions
Doctor-Visit Organizer
Write the plan in plain language before leaving the appointment.
Page 2 of 2 · During and after the visit
What the healthcare professional thinks is happening
Medicine plan
| Medicine | Start / stop / change | New directions | Reason |
|---|---|---|---|
Do not change or stop a medicine unless the prescriber or pharmacist confirms the plan.
Tests, referrals, and care instructions
| Test, referral, or instruction | Where / with whom | Date or deadline | Who will arrange it |
|---|---|---|---|
What to monitor at home
When to call and when to get urgent help
Follow-up
Call 911 for trouble breathing, chest pain, stroke signs, loss of consciousness, severe bleeding, serious injury, or suspected overdose.