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A printable sheet for your next care team visit

Appointments go quickly. This one-page sheet gives you a place for the numbers since last time, your top three questions, and what you and your care team decided, so you leave with it written down.

Prints on one page, US Letter or A4.
How people use it
  1. Fill in the top half before

    A day or two before, write down your numbers since last time and the three questions that matter most.

  2. Write during the visit

    Note what you decided, what to watch for, and when to get in touch. It’s fine to ask your care team to slow down.

  3. Keep it for next time

    Keep the sheet with your notes, so next time you can start from where you left off.

Here’s what prints

My care team visit

Fill in the top half before you go. Write the rest during or right after.

Date Seeing
1 · Since last time Numbers to bring, from your notes or log
BMs a day, usuallyMost BMs in one dayDays with bloodDays with urgencyPain, usually (0 to 10)Nights woken up
Compared with before: Better About the same Worse Not sure
What else was going on (stress, travel, being unwell, changes in eating or sleep)
2 · My top 3 questions The ones I most want answered today
1
2
3
3 · What we decided
4 · What to watch for, and when to get in touch
How to reach them Out of hours
5 · Next steps
Next appointment Anything to do before then
For your own notes. This sheet isn’t medical advice. For medical questions, talk with your care team. Free from flarelyapp.com/tools

Tips for using the sheet

  • Numbers beat adjectives. “Four BMs a day, up from two, and eight days with a little blood” is easier to talk about than “it’s been rough”. Your notes or a weekly log sheet make the top section quick to fill in.
  • Pick three questions. Appointments are short. Writing your top three first means the ones that matter most get asked, even if time runs out.
  • Write the answers down. It’s fine to ask your care team to repeat something, explain it another way, or wait while you write. Some people bring someone along to take notes.
  • Ask when to get in touch. Section 4 is for what your care team tells you to look out for and how to reach them, in their words.

For more on describing the last few weeks clearly and questions people find worth asking, read our guide: Questions Worth Asking Your Care Team.

How Flarely helps

If you log in Flarely, you can make a 30-day summary PDF in one tap. It lays out your BMs, blood and urgency, meals and stress on a page you can pull up on your phone or send to your care team, so the numbers for the top of this sheet are in one place.

The 14-day plan ends with your own summary on day 13: what you remembered next to what you logged, and your questions side by side.

Download on the App Store Free to download. The yearly plan starts with a 14-day free trial.

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