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Menu

The following forms can help you take charge of your health. They offer sample questions to ask your doctor, diagnosis checklists, sample medical information request forms, and more.

Click on the links below to save or print these forms.

Cancer Diagnosis ChecklistHealthy Lifestyle Checklist
Choosing a Healthcare ProviderPreparation for Surgery Checklist
Choosing a HospitalPreparing for Your Appointment
Health Payment Checklist Requesting Medical Records
Healthcare Advocates ChecklistHeart Attack Risk Checklist
Healthy Hospitalization Checklist Web Research Checklist
Insurance Records for Hospital Stays ChecklistResults of the Appointment
Questions for Integrative Therapies Providers Track Your Medical Tests and Procedures
Medication Questions Medication List
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University of Minnesota's Earl E. Bakken Center for Spirituality & Healing

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  • One Stop
  • My U
© 2023 Regents of the University of Minnesota. All rights reserved. The University of Minnesota is an equal opportunity educator and employer. Privacy Statement
  • be MINDFUL
    • Explore
    • Benefits
    • Get Started
    • How It Works
    • Evidence
    • Address Stress
    • Cope with Pain
    • Racial Justice
  • live HEALTHY
    • Diet & Nutrition
    • Physical Activity & Fitness
    • Sleep
    • Stress Mastery
    • Thoughts & Emotions
    • Healthcare
  • create CONNECTION
    • Personal Relationships
    • Your Community
  • feel SAFE
    • Be As Safe as You Can
    • Face Fear and Anxiety
    • Protect Others
    • Rethink Money
  • find MEANING
    • Life Purpose
    • Spirituality
  • healing ENVIRONMENTS
    • At Home
    • In Nature
    • Planetary Health
  • Manage Health Conditions
    • Anxiety
    • Arthritis
    • Autism Spectrum Disorders
    • Back Pain
    • Cancer
    • Cancer Survivorship
    • Childbirth
    • COVID-19 and Anxiety
    • Depression
    • Diabetes
    • End of Life and Hospice Care
    • Headaches
    • Heart Disease
    • Irritable Bowel Syndrome
    • Medical Trauma
    • Menopause
    • Migraines
    • Parkinson's Disease
    • Pregnancy
  • Try Holistic Practices
    • What Are Holistic Practices?
    • Acupuncture and Traditional Chinese Medicine
    • Aromatherapy
    • Ayurvedic Medicines
    • Botanical Medicine
    • Chiropractic
    • Clinical Hypnosis
    • Craniosacral Therapy
    • Creative Therapies
    • Food as Medicine
    • Guided Imagery
    • Healing Environments
    • Healing Touch
    • Holistic Pregnancy and Childbirth
    • Intuition in Healthcare
    • Massage Therapy
    • Mind-Body Therapies
    • Mindfulness
    • Naturopathy
    • Osteopathic Medicine
    • Prayer
    • Qigong
    • Reflexology
    • Reiki
    • Shamanism
    • Shiatsu
    • Social Support
    • Therapeutic Touch
    • Tibetan Medicine
    • Yoga