Questions for your appointment

Questions for your appointment

Your appointment

Everything can stay empty. Anything left empty becomes a line to fill in by hand.

For example: the GP, the neighbourhood team, the council, school or the UWV (the Dutch employee insurance agency).

Date and time can stay empty.

For example: your partner, a friend or your support worker.

This is what your list looks like

This is what goes on paper. You write on the empty lines by hand.

E-powerment

Questions for my appointment

With
Not filled in yet
When
Not filled in yet
Who is coming
Not filled in yet

What I take with me

  • ID
  • Health insurance card
  • Letters about the appointment
  • Medicines or list of medicines
  • This list

What I want to say

Nothing filled in yet.

What I want to ask

  1. 1Empty question

    Answer

  2. 2Empty question

    Answer

  3. 3Empty question

    Answer

What we agree

You write here during the appointment.

Next appointment:

Made with ‘Questions for your appointment’ on e-powerment.nl

How it works

The list is for an appointment with, for example, the GP, the neighbourhood team, the council, school or the UWV (the Dutch employee insurance agency). You make it beforehand, so you do not have to remember everything during the appointment. You see the sheet as it comes out of the printer: on a big screen while you fill it in, on a phone at the last step. It is A4, with empty lines under each question for the answer. At the bottom there is space for what you agree and for the next appointment.

  1. Write down who your appointment is with, and when. Is someone going with you? Write that down too.
  2. Write down what you want to tell them. For example, what is going on, and since when.
  3. Write down your questions, one per line. Not sure what to ask? Then choose a question from the examples.
  4. Tick what you are taking with you.
  5. Print your list and take it with you. During the appointment, write the answers on the empty lines under your questions.

On paper

You can also make the list by hand. Take a sheet of paper and write down these questions, with space underneath:

  • Who is my appointment with, and when?
  • Who is going with me?
  • What do I want to say?
  • What do I want to ask? Leave a few lines free under each question for the answer. Not sure what to ask? For example: What will happen now? What can I do myself? When will I hear more? Who can I call if I have another question?
  • What am I taking with me? Think of your ID (passport, ID card or driving licence), your health insurance card, letters about the appointment, your medicines or a list of them, and this list.
  • What do we agree? And when is the next appointment?

Good to know

  • Everything can stay empty. Whatever you do not fill in becomes an empty line on paper. You can write something there by hand later, also during the appointment.
  • At the start of the appointment, put your list on the table. Say that you have written down a few questions.
  • Do you not understand something? Ask them to explain it again, in other words.
  • Write the answers down straight away. Or ask the person who goes with you to do it. Do you want to bring someone? Then ask if that is possible when you make the appointment.
  • Is your appointment about a treatment? Then you can ask these three questions: What are my options? What are the pros and cons of those options? What does that mean in my situation? They come from the campaign 3 goede vragen (three good questions) from the Patiëntenfederatie Nederland, the Dutch patients' federation  (external website).
  • Print your list before you close the page. Nothing is saved or sent, so after that everything is gone.
  • Make somethingComic maker

    Comic strip conversation

    Turn what happened into a comic strip: who was there, what everyone said and what everyone thought. Then draw what you could do differently next time.

    For: On your ownWith your client

  • Make somethingCard maker

    What helps me

    Make a small card about what helps you when things are not going well. Print it, fold it and keep it with you.

    For: On your ownWith your client

  • Conversation aid

    Feeling words

    Find words for how you feel. Choose a feeling, then the words that fit and how strong it is. On your own or with someone who helps you.

    For: On your ownWith your client

Is something missing?

Does something not work, or are you looking for a tool that does not exist yet? Let us know, a few words is enough. We read everything.

Send us a message [email protected]