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☀️ Free printable: bring this to your appointment

By CSE Team · Last updated: October 28, 2026

Appointments go by fast. This warm, one-sheet checklist helps you (or the person caring for you) walk in with your medicines, side effects, what you've tried, and your questions ready, so the visit feels calmer and more useful.

⬇️ Download the checklist (PDF, 2 pages)   Open it to print

What's on the sheet

• My drug list — name, dose, and schedule.
• Side effects I'm having — start date, how often, and severity from 0 to 3.
• What I've tried — home tips and whether they helped.
• Other medicines and supplements, including over-the-counter ones.
• Questions for my team and space for what they tell you.
• Call your oncology care team right away if you have: a fever of 100.4°F (38°C) or higher (CDC), shaking chills, new shortness of breath or chest pain, or anything that suddenly feels much worse, plus a line for your team's after-hours number.

How to use it

1. Print a copy the day before your visit (or keep a blank pad of them).
2. Fill it in together if you like. Caregivers, this is a lovely way to help.
3. Bring it to the appointment, or snap a photo and send it through your patient portal.

Pair it with our free weekly side effect tracker for day-to-day notes. See also the caregiver guide.

Questions people ask

Is the checklist free?

Yes. Print as many copies as you like, and share it with anyone who could use it.

Do I have to fill every line?

No. Fill what you can. Even a short list of medicines and one or two side effects helps your visit go more smoothly.

Can a caregiver fill it out?

Absolutely. Many people fill it in together the night before an appointment.

Written by the CSE Team from FDA labels and leading cancer centers. Not medical advice. · Last updated: October 28, 2026 · How we write