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ED Visit Companion

Dr. Eric Cummins, MD
Saved
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This autosaves as you go. Close the tab, lock your phone, whatever. It'll be here when you come back.
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Your notes stay on this device. Nothing you type here is sent to us, stored on a server, or visible to anyone else. Avoid entering sensitive details if this isn't your own phone.
1

Why I Came In Today

In your own words, what brought you here?

2

Symptoms I Want to Mention

3

Questions for the Doctor

Jot these down as you think of them, even mid-visit.

4

What the Doctor Told Me

Write down what you hear, in plain language.

5

Medicine or Treatment Given

6

Before I Leave, I Need to Understand

Check these off as they're covered before you go.

7

Follow-Up Plan