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:

1. __________________________________________________________________

   __________________________________________________________________

   __________________________________________________________________

   __________________________________________________________________

2. __________________________________________________________________

   __________________________________________________________________

   __________________________________________________________________

   __________________________________________________________________

3. __________________________________________________________________

   __________________________________________________________________

   __________________________________________________________________

   __________________________________________________________________