Talking With Your Doctor Worksheets
For your convenience, use these worksheets to organize your questions, family and medical history, and information when talking with your doctor. You can download, print, and copy the worksheets.
Worksheet: Recording your family health history
A family medical history can identify people with a higher-than-usual chance of having common disorders, such as heart disease, diabetes, and more. This form can help you organize your thoughts about conditions and illnesses that have affected your family members.
View Worksheet 1: Family Health History (PDF, 107K)
Worksheet: Questions to consider when choosing a new doctor
Use this worksheet to answer some questions for, and about, a new doctor you are considering.
View Worksheet 2: Questions to Ask Your Doctor (PDF, 112K)
Worksheet: Life changes to discuss with your doctor
It's important to tell your doctor about any changes in your life since your last appointment. Use this worksheet to help you record what you want to discuss with your doctor during your next visit.
View Worksheet 3: Changes to Discuss (PDF, 122K)
Worksheet: Prioritizing concerns to share with your doctor
Use this form to help organize your thoughts about any health or other concerns you want to discuss with your doctor.
View Worksheet 4: Concerns (PDF, 107K)
Worksheet: Tracking your medications
This worksheet can help you keep track of different medicines, including vitamins, over-the-counter drugs, and prescriptions.
View Worksheet 5: Medications (PDF, 118K)
This content is provided by the NIH National Institute on Aging (NIA). NIA scientists and other experts review this content to ensure it is accurate and up to date.
June 10, 2021