Start with your own goals
Write down what you hope a consultation will help you understand. Bring questions about your diagnosis, daily activities, priorities, and what a meaningful improvement would look like to you. A qualified clinician can help interpret those goals in the context of your circumstances.
This worksheet organizes a conversation. It does not score options, assess eligibility, or decide which treatment you should have.
Record the proposal and alternatives
Ask for the exact procedure or product, the condition or purpose being addressed, who would perform it, and how the proposed outcome would be measured. Ask what evidence applies to your situation and what remains uncertain.
Record established alternatives and ask what choosing to wait might mean. Keep a space for “not yet answered” so uncertainty remains visible rather than becoming an assumed benefit.
Prepare for another opinion
Ask what records another clinician would need and how to obtain them. Bring the proposed plan, relevant test results, and your written questions. A second opinion is an opportunity to understand the options and any disagreement between recommendations.
Before agreeing to care, clarify the number of visits, costs, recovery instructions, who is responsible for follow-up, and whom to contact about complications or unexpected symptoms. Obtain the clinic’s instructions for urgent concerns directly; a worksheet is not an emergency-care guide.
Your printable worksheet
Print this page and write on your copy. This worksheet does not collect or save your answers.
My goals and priorities
Diagnosis or purpose to discuss
Exact procedure or product proposed
Who would evaluate me and perform the procedure
Evidence that applies to my circumstances
Benefits, risks, and uncertainties to discuss
Alternatives, including waiting
Number of visits, recovery, and practical needs
Total costs and coverage questions
Clinician responsible for follow-up
Contact and plan for complications
Records and unanswered questions for another opinion
Sources and editorial context
This reference was compiled from the sources below and has not received independent clinical review. Use it to understand terms and prepare questions for a qualified professional who can consider your circumstances.
- Discussing health decisions with your doctor · National Institute on AgingReference checked 2026-10-02
- Evaluating health information · National Library of MedicineReference checked 2026-10-02
- Preauthorization · HealthCare.govReference checked 2026-10-02