Questions for my appointment

About this sheet

Medication appointments are often short, and it is easy to leave one realizing you forgot to mention something. This sheet is a simple way to organize your thoughts beforehand. Fill in what applies, print it or keep it on your phone, and bring it with you. It is not a form anyone collects. It is just for you.

How I've been feeling

Since my last appointment, my mood and anxiety have been:

• Better
• About the same
• Worse
• Mixed, some better and some worse

Notes:

Side effects I've noticed

• Nausea or stomach upset
• Headaches
• Trouble sleeping
• Feeling tired or drowsy during the day
• Feeling restless, jittery, or anxious
• Sexual side effects
• Changes in appetite or weight
• Sweating
• Something else

For anything I checked, when it started and how much it bothers me:

How the medication seems to be working

• It seems to be helping
• I am not sure yet
• It does not seem to be helping
• I have missed some doses

Notes:

Questions I want to ask

Things to confirm before I leave

• What dose I am taking, and whether it is changing
• When my next check-in should be
• Which side effects are worth calling about
• What to do if I miss a dose