APPOINTMENT AGENDA — BLANK TEMPLATE

Prepared on: ____________________
My main concern or priority: ____________________

What I noticed, with dates: ____________________
What is approximate, uncertain or not recorded: ____________________
How this affected my daily life: ____________________

Three questions I want to discuss:
1. ____________________
2. ____________________
3. ____________________

Notes from the appointment, in my own words: ____________________
The next step and when: ____________________
What I need clarified before I leave: ____________________

Original blank writing aid from Honest Little Apps, publisher of My Midlife Story. No app required. Not medical advice. Use your own words and share only what you choose.
https://udrwu9c0tjuedqy2.github.io/hla-health/my-midlife-story/symptom-diary-printable/#appointment-example