For general education only. This information does not diagnose a condition or replace medical advice. Your provider will determine which evaluation or treatment is appropriate for you.
Make space for an informed decision
Ask about the exact treatment, why it is being considered, its evidence, and alternatives. Note the plan your provider gives you rather than filling in instructions yourself.
Clarify how to reach the care team and which symptoms need urgent attention. Do not use this sheet to change a prescription.
Name: ____________________________ Date: __________________
Before choosing
Exact treatment name and why it is being considered
Expected benefits, limitations, and alternatives
Approval status, important risks, and interactions
Visit, testing, and medication costs to clarify
The plan discussed
Monitoring and follow up discussed with my provider
Who to contact with questions
Symptoms that need urgent care
After the conversation
My remaining questions and next appointment