CardioTrack editorial

My test-result question sheet

Prepare three questions for your clinician, then note the explanation and follow-up plan you are given. The blank PDF was made in DesignCraft and is one A4 page.

Download the blank question sheet (PDF, 36 KB)

No account or online data entry is needed. Print the PDF or keep it with your appointment papers. This page has no data-entry fields and does not collect your report details.

Read the question-list guide | Report index

Before the conversation

Identify the report by its title, date if shown and ordering clinic. Keep the full original available. Choose three questions that matter to you.

1. What would I like the clinician to explain?
2. What is still unclear to me?
3. What do I need to know about the next step?

What to write down

The explanation I was given

Use your own notes alongside any written clinical instructions.

The agreed next step and who arranges it

Include any action you need to book or confirm.

Timing and review

Copy the timeframe and review date you are given, rather than guess.

Contact and unresolved questions

Note whom to ask if a question remains or an expected appointment does not arrive.

Say the plan back in your own words and ask whether you understood it. Request written instructions when useful. Keep completed copies private.

This is our original conversation aid, not an official or validated clinical checklist. It does not interpret a test or assess whether a result or symptom can wait. Follow urgent instructions from your care team and do not delay needed care to complete it.