Preparing for Your Visit: Checklist + Medicine List Patient Handout (Editable)

WHAT YOU GET

A visit-prep checklist on the front and a fill-in medicine list on the back, so patients come in organized.

FILES

- preparing-for-your-visit-color.pdf: full color, 2 pages (front and back), US Letter

- preparing-for-your-visit-print-grayscale.pdf: for black-and-white printers and copiers

- preparing-for-your-visit.docx: editable Word version

- README-Start-Here.txt: printing tips and license

PAGE COUNT

2 pages (front and back)

FORMAT

US Letter (8.5 x 11 in). Color PDF, grayscale PDF and editable Microsoft Word .docx (also opens in Google Docs and LibreOffice). Delivered as one .zip file.

Instant digital download: your download link appears right after checkout and is emailed to you. No physical item is shipped.

HOW TO EDIT THE WORD FILES

1. Download and unzip the file on a computer.

2. Open any .docx file in Microsoft Word, Google Docs (File > Open > Upload) or free LibreOffice.

3. Optional: click the small header line at the top of the page and type your practice name, or leave it as-is. The templates look finished either way.

4. Type into the tables or edit any wording for your office, then save and print at 100% (actual size).

WHAT'S INSIDE

- "Before your visit", "Bring with you" and "During your visit" checklists

- Lines for the patient's top 3 questions

- An 8-row medicine list: name, how much, how often, why I take it

- Fields for allergies, pharmacy and emergency contact

- Large 14 pt+ text, high contrast, written at about a 6th-grade reading level

- Sources cited on the page (Medicare.gov, CMS; checked October 2026)

LICENSE

One clinic or practice (all of its locations) may print and hand out unlimited copies to its own patients and edit the Word files for that use. Please do not resell, share or post the files.

PLEASE NOTE

For general education only. Not medical, legal or insurance advice. Not affiliated with or endorsed by Medicare, CMS or any government agency.

AI DISCLOSURE: I wrote this with the help of AI tools and checked it against the official sources listed in the file.

(c) 2026 Clinic Revenue Guidess