# Digestive symptom appointment summary

Use this page to organise observations for a doctor or dietitian. It is not a diagnostic checklist, and you do not need to complete every field before seeking care.

## Main concern

- The symptom or change I most want to discuss:
- When I first noticed it:
- How often it happens:
- How it affects daily life:

## Pattern I have observed

- What tends to happen before or alongside it:
- Times the suspected pattern did not occur:
- Other context that changed, such as sleep, stress, illness, medicines, routine, portion or preparation:
- What is missing or uncertain in my record:

## Timeline

- Earliest relevant date:
- Most recent relevant date:
- Has the frequency, severity or pattern changed?

## Medicines, supplements and relevant care

- Current medicines and supplements, including doses if known:
- Recent changes already discussed with a professional:
- Previous appointments, tests or diagnoses relevant to this concern:

Do not start or stop medicines based on this template. Bring an up-to-date list and discuss questions with a qualified professional.

## Questions for the appointment

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3.

## Supporting record

- Diary dates included:
- Documents or photographs included:
- Anything important the summary leaves out: