1What have you come about?
Search for it, or pick from the lists below. Pick as many as you need — each one gets its own section on the pages that follow.
!Check this first
Read all of these before you fill in anything else. Check any that are true right now — then keep going, or stop and get help.
2What you have noticed
Your doctor will ask most of these. Answering them now means you will not be put on the spot. Not sure is a real answer — use it rather than guessing.
3About you
These are the things most often forgotten, and the things that change what your doctor does next.
4Your health record
The basics a doctor almost always asks for. Fill in what you know and skip what you do not — this part is kept when you switch topics, and everything you add prints on your take-away sheet.
5Take this with you
Show this to your doctor, read it out, print it, or save it as a PDF or Word file with the same colors. Red needs help now, gold is what you said yes to, gray is what you were not sure about, and green is what you ruled out. Go back any time — this updates as you change answers.