pdfty.

Printable Doctor Visit Notes (Free PDF)

One page split in two: what you want to say and ask before the appointment, and what you were told once you are in the room.

Printable doctor visit notes with before and after visit sections
Paper size
Fill & edit free online

Free · no watermark · no sign-up for your first 20 downloads a day

Fillable PDF — type into the fields online or in any PDF viewer before printing.

Appointments are short and memory is worse than anyone expects in a consulting room. The top half of this page is filled in beforehand: a ruled panel for symptoms and changes since last time — when they started, how often, what makes them worse — a checklist of five questions you want to ask, and a small table of the medicines and supplements you take, with their strength and how often you take them.

The lower half is filled in during or straight after the visit. One panel takes what the doctor said: the diagnosis, the test results, what it actually means. The second takes the plan — medicines, tests, referrals, what to change, what to watch for. Across the foot are three short lines: the next appointment, when tests are booked, and what should make you call sooner.

Nothing is printed for you here, because the content is yours: the sheet prescribes nothing, names no medicine and suggests no dose. Tick a question off as you ask it so none are left when you stand up, and write the plan down in the room, in the words you were given, while someone is still there to correct it. Every panel, line and table cell is a form field, so you can type it up afterwards and keep a clean copy. One page, US Letter or A4.

How to use it

  1. 1

    Fill the top half at home

    Write your symptoms, list the questions you want answered and copy your medicines from their labels.

  2. 2

    Print or fill it in

    Print at 100% ("Actual size") so lines and boxes keep their exact spacing, or fill the form fields on screen in any PDF viewer.

  3. 3

    Tick questions as you ask them

    That way none are forgotten in the last minute of the appointment.

  4. 4

    Write the plan down in the room

    Use the lower panels and read the plan back before you leave, so you catch anything you misheard.

Frequently asked questions

Yes. There is no watermark and no sign-up for your first 20 downloads each day; after that a free account keeps downloads going. You may print the file as often as you like for personal, school or business use.
Five question lines and six medicine rows. If you need more, print a second copy — and consider which three questions matter most, since appointments are short.
Yes. The four header fields, both before-visit sections, the medicines table, both after-visit panels and the three lines at the foot are all form fields.
Yes, printed. Writing on paper during a consultation is quicker than typing, and the clinician can see what you have written if you want to show them.
Yes. Choose two-sided printing in the print dialog and one sheet gives you two pages of the same layout. Nothing is printed upside down or mirrored, so both sides read the same way.
No. It is a blank sheet for recording what you measure or do, and it prints no targets, no normal ranges and no doses. What you write on it is for you and your doctor, nurse, therapist or pharmacist to read together.

More free templates

Workout Log18 rows for sets, reps and weight, with warm-up and cool-down strips.Weekly Workout PlanSeven days against warm-up, lifts, accessories, cardio and stretching rows.Water Intake Tracker31 days against eight glasses to tick, with your own daily goal field.

Work with your PDF

Flatten PDF

Flatten form fields and annotations into the page

Merge PDF

Combine multiple PDF files into one document

PDF to JPG

Convert each PDF page to a high-quality image

Sign PDF

Add your signature to any PDF document