Private preparation worksheet

Make the next conversation more useful.

Check off the questions to prepare, then print or download your checklist. Do not enter medical records or personal identifiers.

Independent educationOfficial sources linked

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1. Current coverage

2. Doctors and care

3. Prescriptions

4. Costs and enrollment

5. The next step

Bring private provider and medication details to an appropriate individual review—not a public form or group meeting. Confirm coverage and enrollment with the responsible program.