Doctor Visit Checklist

Printable visit-prep checklist with starter questions by visit type, a 5-question cap, and optional pulls from your med list and symptom diary.

Visit type
Choose a visit type
Visit details
Symptoms timeline

What / when started / triggers / progression.

Questions to ask

0 / 5 selected

    Medications
    Recent test results
    Family history
    Recent symptoms (last 14 days)
    Drafts

    Stored on this device only. Drafts cap at 10; oldest is dropped on the 11th save.

    Visit checklist

    Date
    Provider
    Patient
    Reason

    Symptoms timeline

    Top questions

      Medications

      Recent test results

      Family history

      Recent symptoms (14 days)

      Pick a visit type, check up to five questions, and fill any details you want printed. Sections fill in below as you type.

      Export
      How this works

      Each visit type loads a starter list of 8–12 questions sourced from AHRQ QuestionBuilder, AACE clinical guidelines, ASA pre-operative patient education, and the CareClearly appointment-realism pattern. Edit any row, drag to reorder, delete what you don't need, or add your own.

      The five-question cap mirrors how much can realistically be covered in a 15-minute primary-care visit. Switching the visit type swaps the seeds but keeps any rows you added or edited.

      Pulls from your saved medication list (H5) and pain & symptom diary (H18) are opt-in and only appear when there's data to pull. We never write back to those tools — your data is copied as plain text you can edit before printing. Everything is stored on this device only.