Patient Forms & Worksheets

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NOTE: These forms and worksheets are in PDF format. If you need a different format, please contact us at

  •  Making an Appointment Worksheet - This worksheet walks through the steps of making a healthcare appointment. It has lines to write in information that you might want handy while making the appointment. It also has lines to write in information the office staff might tell you, like the day and time of the appointment.

  •  What to Bring to a Healthcare Visit Checklist - This is a checklist you can use when putting together the things you need to bring to a healthcare visit. It has a second page with extra things to bring to a first visit, or if you haven't seen your healthcare provider in a long time.

  •  Symptoms Worksheet - This worksheet covers the information healthcare providers usually want to know about symptoms. Not all questions apply to all symptoms. But thinking through some of these questions may help you better describe your symptoms or answer your provider's questions.

  •  After the Visit Worksheet - Your provider may ask you to do something after the appointment. This worksheet has a page for each of the main things your provider may ask you to do:

    • Make a follow-up appointment with your healthcare provider
    • See a specialist or make an appointment with a different healthcare provider
    • Get a lab, x-ray, or other test
    • Take a medication
    • Do something to manage your health condition at home
  •  Autism Healthcare Accommodations Tool - This form will guide you through the steps to create a personalized accommodations letter you can print or save and give to your healthcare provider.