It’s important to tell your doctor what’s important to you during your treatment. This will help ensure you get the most appropriate treatment and care.
To help you remember everything you’d like to talk to your doctor about, use this form and take it with you to your next appointment.
You don’t have to do this by yourself. You can ask a friend or family member to complete this for you and can bring them with you to your consultation.
PP-UNP-IRL-0796. Date of preparation: July 2024