Review Material Patient Action Plan

Make the Most of

Each Medical Visit…
and the Time Between Visits

Maybe something
in your life
changed since
your last visit…

… A new job is
making it hard
to stick to your
medicines schedule
… You recently
moved and are
having trouble
getting to medical
appointments

Maybe you have
questions about
healthy living
and healthy
relationships…

… options for
safer sex
… how to reduce
side effects from
medicines

… You’re dating
someone new, but
haven’t talked to
them about STDs
or HIV yet
… You are thinking about having
kids and want
some advice
… healthy ways to
deal with depression
and anxiety

These are all examples of topics
you can talk about with your
medical provider. Together, you
can set a goal – something
you want to work on or
change between now and your
next medical visit to help you
overcome challenges like these.

10_PIC_W3_Action_Plan_v16 12-3-13

Every medical visit gives you a chance to talk with your medical provider about
getting healthy, staying healthy, and keeping others safe.

We believe you can
achieve your goal and
protect your health.

… getting help with
alcohol or drug use.

myAction
Plan
Write your goal and
the steps you’ll take
to reach that goal
on this Action Plan.

At your next medical
visit, talk to your medical
provider about progress
you’ve made and ask for
support if you’ve had any
roadblocks to success.

Date of visit with medical provider:
Issue we discussed:

Solution I agreed to try:

Date of next appointment:

Remember… change is an ongoing process.
Understand that you may make mistakes along the way.
Don’t be afraid to ask for help from friends and family.
Care IS Prevention