Appointment prep sheet

Use this page to prepare for primary care, specialist, or care-planning visits so the most important issues don’t get lost.

1. Visit details

• Provider / clinic:
• Date / time:
• Type of visit (routine, follow-up, new concern, hospital follow-up, etc.):

2. Top 3 goals for this visit

In plain language, list what you most want from this appointment.

3. What has changed since last time?

• New symptoms or behaviors:
• Falls, ER visits, or hospital admissions:
• Changes in medications or doses:

4. Questions you want to ask

List 3–7 questions. Mark the ones that are non-negotiable to get answered today.

5. Follow-up & next steps

• Tests ordered:
• Medication changes:
• Referrals (therapy, home health, specialists, etc.):
• Who is responsible for what, and by when:

Tip: Bring this page and a copy of your medication list to the visit.

Important: This page is a planning aid only. It does not replace medical advice, diagnosis, or treatment.