Step 1 of 4

About your appointment

A few quick details so your summary is tailored to your situation. This takes about a minute.

Your first name (optional)

Used only to personalize your summary. Nothing is stored or sent anywhere.

What type of appointment is this?

First visit with this doctor

Follow-up visit

New or worsening symptoms

Reviewing lab results

Treatment discussion

Which condition(s) are you being seen for? (select all that apply)

Rheumatoid arthritis

Lupus (SLE)

Sjogren's disease

Scleroderma (SSc)

Spondyloarthritis / PsA

Myositis

Vasculitis

Polymyalgia rheumatica

Undifferentiated / not yet diagnosed

Other

How have you been feeling overall since your last visit?

😔Much worse

🙁Somewhat worse

😐About the same

🙂Somewhat better

😀Much better

Anything important that has changed since your last visit?

Step 2 of 4

Your symptoms

Check any symptoms you have experienced since your last visit. Then rate the severity so your doctor gets an accurate picture.

Morning stiffness — how long does it typically last?

None

Less than 15 min

15-30 min

30-60 min

1-2 hours

More than 2 hours

Joints and muscles

Energy, sleep, and general wellbeing

Skin, eyes, and mouth

Chest, breathing, and other

Have you had any flares since your last visit?

No flares

1 flare

2-3 flares

4 or more

Currently in a flare

Anything else you want your doctor to know about your symptoms?

Step 3 of 4

Your medications

List your current medications. Include prescription drugs, over-the-counter medications, supplements, and vitamins. Your doctor needs the full picture.

Current medications

Any medications you want to discuss or ask about?

Any new medications started since your last visit?

Any medications you have stopped or changed?

Step 4 of 4

Questions for your doctor

Select the questions most relevant to you, and add your own. These will appear on your summary so you do not forget to ask them.

Suggested questions based on your situation

Add your own questions

Your appointment summary

Ready to bring to your appointment

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