FIRST PSYCHIATRIST APPOINTMENT — MY NOTES
HopeStage | 13 October 2026
https://www.hopestage.com/research/first-psychiatrist-appointment

Use only the prompts that help. You do not have to fill every space.
This is a conversation aid, not a diagnostic test or medical advice.
Keep completed notes private. Nothing you write in this downloaded file
is submitted to HopeStage.

MY APPOINTMENT
Date and time (including time zone for a video visit):
Clinic / clinician:
Address or video instructions:
Appointment length and arrival time:
Paperwork, referral or results the clinic has requested:
Fees / coverage confirmed with the clinic:
Clinic contact and what to do if I cannot attend or connect:

MY STARTING POINT
The thing I most want help with:
One recent example of how this affects my day:
The question I most want answered:

A SHORT TIMELINE
When I first noticed a change (approximate dates are fine):
How often it happens / whether it comes and goes:
What has changed in my sleep, energy, mood or concentration:
Relevant events, stressors or physical health concerns:
Similar experiences in the past:
Support or treatment I have tried, and what helped or was difficult:
Family mental health history, if known:
Anything I am unsure of or would like checked in my records:

MEDICINES AND OTHER PRODUCTS
Include prescribed medicines, nonprescription products, vitamins,
herbal remedies and supplements. Use labels or ask your pharmacy if unsure.
Name | prescribed dose, if applicable | how I take it | questions or concerns:

Known allergies or previous reactions:
Relevant alcohol or other substance use to discuss:
Do not change or stop prescribed medication on your own.

WHAT WOULD HELP ME TAKE PART
A support person and what I would like them to help with:
Topics I would prefer to discuss privately:
Language, hearing, accessibility or communication arrangements to request:
A sentence I can use if speaking is difficult:

QUESTIONS FOR THE CLINICIAN
What do you think so far, and what is still uncertain?
What options might help in my situation?
If medication is proposed: benefits, risks, alternatives and review plan?
Who receives information from this visit, and what are the privacy exceptions?
My other questions:

BEFORE I LEAVE
Key points from the conversation:
The next step and who will arrange it:
Any instructions I need clarified or written down:
How and when I will receive any results:
Who to contact with concerns, including outside clinic hours:
Next appointment or review date:

AFTER THE VISIT
Something I remembered later:
How the clinic says I can share an additional question:

If you cannot stay safe or are in immediate danger, contact local
emergency services or go to the nearest emergency department.