Free printable GLP-1 template
GLP-1 Doctor Appointment Checklist
Prepare a concise medication history, symptom summary, refill details, and prioritized questions for your next GLP-1 appointment.
No sign-upPrint-readyOptional iPhone reminders
Make the most of a short appointment
Bring a current medication list, summarize what changed since your last visit, and put your three most important questions first. Write down updated instructions before you leave.
Before your appointment
- Bring every prescription, over-the-counter medicine, vitamin, herb, and supplement—or one current list.
- Bring your recent dose, injection-site, and symptom notes.
- Note any medication changes, new symptoms, or effects on daily life.
- Check whether you need a refill or prior authorization.
- Bring the current prescription label or Medication Guide when you have a question about it.
- Ask whether the clinic wants records, test results, or forms in advance.
Your three priorities
Put the questions or changes that matter most at the top.
1.
2.
3.
Current medication and recent history
Medication and strength from label
Current written dose instructions
Most recent recorded dose date
Skipped or corrected entries
Doses or devices remaining
Pharmacy / refill status
Symptoms or changes since the last visit
When they started and their effect on daily life
Other medicines or supplements to discuss
Questions you may want to bring
Choose only the questions that apply to you and add your own.
- What should I track between visits?
- What should I do if a dose is missed or I am unsure whether it was taken?
- Which symptoms should prompt a call, and which require urgent care?
- Could another prescription, over-the-counter medicine, vitamin, or supplement affect my treatment plan?
- Have any of my written instructions changed?
- Who should I contact if I have a question after this visit?
- When should I follow up?
- Do I need a refill, prior authorization, test, or referral?
My question
My question
During and after the appointment
Appointment date and clinician
Next appointment or follow-up
Medication changes — copy exactly
Refill or pharmacy actions
Tests or referrals
Who to contact with questions
Instructions I received
Questions I still have
A simple way to close the visit
Before leaving, repeat back anything that is unclear and write updated instructions exactly as they were given. Confirm who to contact and what the next follow-up step is.