Your List of Questions to Ask the Doctor

When you visit the doctor, it's good to ask questions! Here is a form that you can use to write down questions. 

Print and download the article here!

Para ver en español, haga clic aquí. Upang tingnan sa tagalog, mag-click ditto

My List of Things to Ask the Doctor

Questions my team and I want to ask the doctor: 

• _________________________________________________

• _________________________________________________

• _________________________________________________

• _________________________________________________

• _________________________________________________

 

Questions about my health I should always ask:

1. Do I need any of these tests?

High Cholesterol - Men and Women
Type 2 Diabetes - Men and Women
Colon Cancer - Men and Women
Breast Cancer - Women Only
Cervical Cancer - Women Only
Osteoporosis - Men and Women
Prostate Cancer - Men Only
Other: ___________________________

 

2. Do I need any of these shots?

Flu
Pneumonia
Whooping Cough
Tetanus
Shingles
Other: ___________________________

 

3. What can I do to stay healthy?

Get more exercise
Eat healthy foods
Quit Smoking
Other: ___________________________
Other: ___________________________