TREATMENT DIARY
 
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 My Appointments | My Contacts | My Questions | Common Questions
Appointments

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Doctor visit,
Labs,  Scans, 
Calls,  Medications schedule ...		        

 

  
Do you have a referral?        

 

  
Do you have your questions?    

 

      
Contacts
 Oncologist: Phone:
Fax:
  Nurse: Phone:
Fax:
  Pharmacy: Phone:
  Insurance: Phone:
Fax
  Other: Phone:
Fax:
Questions for your doctors and nurses:
Answers:
   
   
   
   
   

Common: TREATMENT: What is the goal of the treatment? | What is the data for the treatment? | What toxicity and/or risks are associated with the treatment? | Can I still use standard treatments if this treatment doesn't work? |  TESTS & SIDE EFFECTS: What tests are you ordering & what do they measure? | What is the meaning of my test results? | What prescriptions do I need & how should they be taken and stored? |  What signs or changes should I report immediately? | What side effects of treatment should I expect? | What side effects may I see that are not dangerous? | What diets, supplements or medications should I use/avoid? | GENERAL: What is the best way and time to communicate with you about my concerns (phone? fax? email?) | How often should I schedule visits? | What other resources are available to me: nutrition? psychosocial? sexual?