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My Questions for This Visit

Use this card to list the questions you want to ask during your medical visits. Select for a brochure that gives you tips to use before, during, and after your medical appointments.

You might have questions about:

  • Your medicines.
  • A medical test you need.
  • A surgery you need.

What are the top three questions you want to be sure to ask during your appointment? List them here:

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Page last reviewed August 2011
Internet Citation: My Questions for This Visit. August 2011. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/patients-consumers/patient-involvement/ask-your-doctor/tips-and-tools/questioncard.html