Checklists

Downloadable Checklists

These worksheets can be copied, printed, or adapted into PDF downloads.

Appointment Prep Sheet

  • Main concern
  • Date symptoms started
  • What makes it better or worse
  • Top three questions
  • Current medications
  • Allergies and reactions
  • Recommended next step
  • Follow-up plan

Before a Procedure Checklist

  • What problem is this procedure meant to address?
  • What benefit should I realistically expect?
  • What are the common and serious risks?
  • Are there alternatives?
  • What happens if I wait?
  • Who will perform it?
  • What will recovery be like?
  • Is the provider and facility in-network?
  • Do I need prior authorization?
  • Is a second opinion reasonable?

Personal Medical Information Sheet

  • Full name and emergency contact
  • Primary doctor and pharmacy
  • Medical conditions
  • Current medications
  • Allergies and reactions
  • Surgeries and hospitalizations
  • Devices or special needs
  • Medical documents and where they are stored