Personalized Doctor Discussion Guide

Use this tool to help you make the most of your doctor visit. Create a personalized guide to help you discuss your health with your doctor.

It will take less than 2 minutes to complete.

Click here to download a non-personalized doctor discussion guide.

Start

Step 1

Create Your Guide

Edit

Have you been diagnosed with severe aortic stenosis?

Select the symptoms you are experiencing and use the slider to indicate the severity level of that symptom (select all that apply).

Symptoms
Mild Progression Severe
1 5
1 5
1 5
1 5
1 5
1 5
1 5
1 5
1 5
1 5

Tell us a little bit about yourself


How were you feeling 6 months ago?

How consistent are your symptoms now?


Choose questions to ask your doctor

Select additional questions you want to add to your Doctor Discussion Guide.

  • How is aortic stenosis diagnosed?

  • I am experiencing one or more symptoms of aortic stenosis. What should I do?

  • What types of tests will I need to go through for diagnosis?

  • If I have severe aortic stenosis, what are my treatment options?

  • What types of tests will I need to go through for determining the best treatment option for me?


Select the symptoms you are experiencing and use the slider to indicate the severity level of that symptom (select all that apply).

Symptoms Severity
Mild Severe
Mild Severe
Mild Severe
Mild Severe
Mild Severe
Mild Severe
Mild Severe
Mild Severe
Mild Severe
Mild Severe

Tell us a little bit about yourself


How were you feeling 6 months ago?

How consistent are your symptoms now?


Choose questions to ask your doctor

Select additional questions you want to add to your Doctor Discussion Guide.


Step 2

Personalize Your Guide

Edit

Personalize your guide by entering the information below.
This step is optional.

Next Appointment Time

Enter your ZIP Code to add the three closest specialized Heart Teams to your Doctor Discussion Guide.

Step 3

Finish Your Guide

example form

Your Doctor Discussion Guide has been created. Select “Finish” to view your guide in a new window where you can then email, save, or print.

Learn more about the Heart Team.

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Learn more about aortic stenosis.

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