My Health Checklist

My Health Checklist is designed to help older adults get the most out of their medical appointments. This guide helps you think through all aspects of your health — what’s going well, what could be better, and your questions or concerns. Being prepared means that you can make sure your appointment focuses on the things that matter most to you.

Download My Health Checklist

Download in English

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Download in Spanish

Note: Before filling in the guide, save it to your desktop. Otherwise, anything you type will not be saved.

My Health Checklist is an Age-Friendly Health Systems resource for older adults, made possible through funding from The John A. Hartford Foundation.

Frequently Asked Questions

How can I make text larger in the guide?

To view the guide on a Windows computer:
- Open the guide
- Click the “zoom in” button (the “+” icon) to make the text as large as you like
To print the guide on a Windows computer:
- Open the guide and press print
- On the print screen, click on “Fit” and the printed guide will expand to fill the 8.5” x 11” page
To view the guide on a Mac computer:
- Open the guide
- Click the “zoom in” button (the “+” or magnifying glass icon) to make the print as large as you like
To print on a Mac computer:
- Open the guide and press Print
- On the print screen, click on “Scale to Fit” and the printed guide will expand to fill the 8.5” x 11” page

How can I print the guide?

How can I share the guide?

I am a health care provider. How can I use the guide?

To have more efficient, effective, and productive appointments, share the guide with patients before they come in. Some ways include:

Mail hardcopies to patients before their appointments
Hand a copy to a patient at the end of an appointment for them to use at the next visit
Introduce the guide at the "Welcome to Medicare" visit
Include the guide in the electronic portal (please note, this option is useful for some patients, but others will need a printed copy)

The guide helps older adults think through all aspects of their health — what’s going well, what could be better, and their questions or concerns. Then it helps them prioritize their top questions about what matters most to them.

More Resources

I want to have conversations with the important people in my life about my — or their — wishes for care through the end of life...

Download free guides for getting started from The Conversation Project

I want to think more about what matters most to me in my life and health...

Visit My Health Priorities

I am a caregiver (care partner) or I support an older adult…

For support for you and the older adult you care for, visit Caring for Caregivers

I'm thinking about which questions to bring to my medical appointments…

Download Ask Me 3®: Good Questions for Your Good Health

My Health Checklist

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