On this page
Your next step: Gather the names of the medicines and supplements you already use in one place. Copy details from the packaging or your existing instructions, mark anything uncertain, and bring the list to your practitioner. This sheet records information; it does not decide what you should take or how much.
Print these tables or copy them into your own notes. You fill in your copy outside this website. Yellow on spotyellow.in has no form here for receiving the entries, and the sheet does not check interactions or interpret a prescription.
Give the list a date
Use a date so you and the practitioner can tell which version you brought. You can use initials rather than a full name on a copy you carry.
Prepared on: ____________________
Name or initials: ____________________
Appointment this copy is for: ____________________
Last checked against my packaging or instructions: ____________________
Keep the original prescription and packaging available if you have them. A copied line may miss a detail. If you cannot read something, leave it marked “unclear” and ask the practitioner or pharmacist to help identify it. Do not guess from a tablet's colour or shape.
Record what you already use
Use one row for each item you want the practitioner to review. Include products you buy yourself as well as prescriptions. This is an inventory of your own items, not a suggested shopping list.
| Name exactly as written | Strength or formulation on label | Where I copied this from | Question or uncertainty |
|---|---|---|---|
If a label has several names, copy them rather than deciding which one matters. For a product with several ingredients, note where the full label is available. You can bring a photo of that label if the clinic accepts it. Avoid including unrelated personal information in the photograph.
Separate written instructions from what you remember
Use the next table to record the information you want clarified. Copy existing instructions as written; do not calculate a replacement dose, combine instructions from different prescriptions or use this worksheet to decide between conflicting directions.
| Item name | Existing instructions and their date | What I want to clarify with the practitioner |
|---|---|---|
Anything I cannot identify or read: ____________________
Who I will ask to clarify it: ____________________
If your actual routine differs from the instructions, describe that in your own words during the consultation. An honest account is more useful than a list edited to look consistent. The practitioner can discuss the question with you; this sheet cannot supply a corrected treatment plan.
Keep changes and questions visible
If you want to discuss a recent change, write down what happened and the approximate date. Mark a date as approximate when you are unsure. You do not need to explain why the change happened before raising the question.
The item or change I want to discuss: ____________________
Date or approximate period: ____________________
My question, in my own words: ____________________
Examples of organisational questions are “Which version of these instructions should I bring?” and “Who should explain this label to me?” Questions about starting, stopping, doses or side effects belong with a qualified practitioner. Do not wait to finish this sheet if you need medical help.
Choose how to carry and share the copy
Keep the completed list somewhere you can find it for the appointment. Before sending it to a clinic, confirm the recipient and the method it wants you to use. A family message group and a clinic contact are different audiences.
Recipient and sharing method confirmed: ____________________
Copy sent or brought on: ____________________
Questions still awaiting an answer: ____________________
For the wider set of reports, use the existing-records index. To choose your main questions, use the appointment preparation sheet. Those pages organise documents and priorities; this one keeps product names and uncertain details together.
Ask Yellow where to start if you want to understand care roles. Yellow for Hormones has programme information if you wish to explore it. This printable list does not enrol you in a programme or send your information anywhere.
This resource provides general information and does not diagnose a condition or replace advice from a qualified practitioner.