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Health and medical records · HM-219 · Form

Appointment Questions and Notes Sheet

Free printable appointment sheet — questions written beforehand, answers written during and what was agreed afterwards, on one page. PDF and browser versions.

First page of the Appointment Questions and Notes Sheet printable — the questions you actually meant to ask, written down before you go
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One page. The A4 and US Letter files are laid out identically, so neither is shrunk to fit.

Print it and write on it

Fillable PDF type and save

Or no download needed

Fill it in online

The fillable versions have real form fields — open them in any PDF reader, type into them and save. Printing help.

Fill it in online

The same sheet, on screen. Tick, type, add or remove rows, then print it or download the completed version as a PDF. Everything stays in your browser — your entries are kept in this browser's own storage on this device, nothing is uploaded, and there is no account.

Who this is for

One page to take into an appointment. The questions go down the left before you go, the answers get written beside them while you are in the room, and what was agreed goes at the bottom before you leave the building — so you come out with the conversation on paper rather than half of it in your head.

Anyone who forgets their questions until they are back in the car park, people seeing a new clinician, relatives going along to take notes for somebody else, and anybody whose appointments are short and infrequent.

What this helps you track

  • The questions you actually meant to ask, written down before you go
  • Why each one matters to you, so it survives being rushed
  • The answer you were given, in the words it was given in
  • What was agreed, who is doing it and by when
  • Anything left unanswered, ready for the next appointment

How to use it

  1. Fill in the appointment details at the top: date, time, who with and where.
  2. Write your questions the day before, not on the way — put the most important one first, because appointments run short.
  3. Say in a few words why each question matters to you; it makes the question easier to ask and harder to brush past.
  4. Write the answer beside the question while you are still in the room, in the words you were given rather than your summary of them.
  5. Before you leave, fill in what was agreed, who is doing it and by when, and ask if you are not sure.
  6. Take the unanswered questions forward to the next appointment, or fill the sheet in online and save it in your own browser.

Formats

  • Printable PDF (A4 and US Letter)
  • Fillable PDF with form fields
  • Fill in online, saved in your browser

The printable is laid out inside a box that fits both A4 and US Letter, so the two files are identical and neither one is scaled. The fillable PDF has real form fields. The online version keeps what you enter in your own browser and builds the completed PDF on your device.

How to print

Download the A4 or US Letter file to match the paper in your printer, open it in a PDF reader and print at 100% — not "fit to page", which shrinks the writing space. Both files leave a 14 mm margin, which clears the unprintable edge on home printers. To print the online version with your entries in it, use the Print this sheet button, which prints only the sheet and none of the page around it. More on printing.

Questions

Is it rude to bring a list in?

Most clinicians would rather you did. A written question gets a clearer answer than one half-remembered at the door, and the appointment tends to go faster, not slower.

How many questions should I put down?

As many as you want, in the order that matters to you, and accept that a short appointment may not reach the bottom. Anything left over goes on the next sheet.

Does the sheet suggest what to ask?

No. The questions are yours, about your own care. There is no list of suggested questions on it, because a question that matters to somebody else is just something taking up the time you have.

Should somebody come with me?

If you can, and if you want to — two people remember more than one. Write down who came, because it helps later when two accounts of the appointment differ.

Related resources

Also in the library

Printable sheets, workbooks and tools on the same subject.

One to One Meeting Record

Give a regular short conversation some continuity, by starting from what was agreed last time instead of from a blank page.

SR-08 1 page Staff records

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