Empowered Patient Online Toolkit

Tab 2: Questions and Notes

Use this section to write down any questions or notes you’d like to discuss with your doctor or nurse before your appointment, and to store the notes you take during your appointment. In addition to using the templates provided here, you can also keep a quantity of blank, loose leaf paper in this section to take additional notes.

Questions to Ask Your Medical Team

Print out this checklist to ensure that you’re getting all the information you need from your PH team. This list includes questions to ask during your initial interview with a PH-treating doctor, at your first appointment, and before any tests, procedures or changes to your treatment plan.

Question Tracker

Use this worksheet to keep track of non-urgent questions between appointments. At your next appointment, take notes on your doctor’s answers in the space provided.

Weekly Symptom Log

Use this worksheet to make notes about any symptoms or weight fluctuation you may experience between doctors’ visits. This worksheet also provides space for you to track your food and fluid intake to help you and your medical team monitor your fluid rention, a problem for many PH patients. Together, you and your healthcare provider can review your progress and make sure you’re getting the most out of your treatment plan. Note: If you experience any unexpected weight gain or worsening of symptoms, contact your pulmonary hypertension team immediately.

Appointment Prep Worksheet

Use this worksheet to prepare for each doctor’s appointment by summarizing any changes you’ve noticed since your last visit and any questions you’d like answered during the appointment.

Appointment Summary Worksheet

Fill out this worksheet with your doctor or nurse after each appointment to ensure that you understand important instructions and treatment plan changes. Photocopy for your other doctors as necessary to keep them up-to-date. Keep copies of each summary worksheet so you have a detailed and accurate record of your healthcare history. As time goes on, you can transfer older appointment summary worksheets to your Medical Records tab.

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