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Patient Handouts

Download patient tools such as food and exercise diaries, a chronic pain medication agreement, and a new patient welcome letter.

Chronic Care Management Patient Letter

A letter that explains chronic care management services to patients
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Chronic Pain and Opioid Medication Policies

An example of a handout given to patients who have chronic pain explaining the practice's policies for opioid medication therapy, including the patient's responsibilities to remain a recipient of pain therapy as well as the practice's obligations to provide good care
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Evaluating the Need for an Interpreter (Spanish)

A patient handout that will help explain to Spanish-speaking patients what they can expect when using an interpreter (an English translation is also available)
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Exercise Diary

A diary to help patients track their daily exercise
Download Format: PDF
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Food Diary

A diary to help patients track what they've eaten to aid in weight loss or other health matters
Download Format: PDF
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General Symptom Diary

A diary to help patients track general symptoms to aid in diagnosis
Download Format: PDF
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Headache Diary

A diary to help patients track their headache symptoms
Download Format: PDF
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Immunization Reminder Letter

A letter to remind parents/guardians that a child is due for immunizations
Download Format: PDF
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Medical Error Prevention

A patient handout that provides 20 tips for preventing medical errors
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Medication Use Agreement

A form that patients being prescribed drugs for chronic pain can sign to signal their agreement not to misuse the drugs
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Mourner's Rights

A patient-education handout that helps prevent health crises in mourning patients and demonstrates that the physician cares
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Patient Assistance Contract

A contract to help patients enrolled in pharmaceutical assistance programs understand their responsibilities
Download Format: PDF
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Patient Welcome

A sample welcome letter for new patients at their first office visit
Download Format: PDF
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Patient-Physician Partnership Agreement

An agreement for a patient and a physician to sign as a step toward better managing a patient's chronic disease
Download Format: PDF
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Pre-Visit Questionnaire

A list of questions the patient completes on paper in the waiting room or through an online patient portal from home
Download Format: PDF
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Sample Letter to Problematic Patients

A follow-up letter that practices can send to patients exhibiting poor behavior with physicians or staff documenting the conversation they had and reinforcing any consequences if the behavior does not improve
Download Format: PDF
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Sleep Diary

A diary to help patients track their sleep patterns
Download Format: PDF
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Sports Physicals

A patient handout to explain to parents why they may need to schedule a well-child exam rather than a "sports physical" for their child
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Understanding Your Health Plan's Rules

A patient handout that explains the general rules associated with referrals, preauthorizations, formularies, and participating providers
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Understanding Your Insurance Coverage

A patient handout that explains the concepts and financial implications of medical necessity and medical benefits and covered and noncovered services
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Understanding Your Medical Bills

A patient handout that assists physicians in dealing with questions patients may ask and with problems that arise when patients misunderstand their insurance benefits
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Voiding Diary

A diary to help patients track their voiding patterns
Download Format: PDF
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Warfarin Dose Reminder Chart

A chart to help patients remember the correct dose of warfarin
Download Format: PDF
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