Personal Health Assessment printable pdf download

Personal Health Assessment

Personal Health

Assessment

In order to manage your treatment effectively, your doctor needs to know how

you’re feeling, how your arthritis is impacting your life, and how well you’re

responding to the medicines you’re taking.

A day or 2 before your next office visit, take some time to answer the questions

below. Then, bring this personal health assessment with you and share it with

your doctor.

See following pages for examples.

Today’s date

Have you experienced any health or life changes since your last visit?

Physical and emotional changes in your life can affect the way your doctor treats your arthritis. Can you think of any

significant life changes or overall health issues you’ve experienced since your last visit?

If so, how have these changes affected your arthritis?

How is your medication routine going?

Changes in the type or number of medications you are taking can affect which medications your doctor recommends for

you. Even over-the-counter medications to treat things like pain, a cold, or allergies can affect your current treatment.

Being upfront with your doctor about which medications you are on is extremely important.

List any prescription medications you’re currently taking:

Personal Health Assessment