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Are You Communicating With Your Physician?

Directions: Using the scale below, circle the appropriate number for each question. Total your responses and find your score at the bottom of the activity.

When I go to my physician for a health problem... Almost Very Frequently Frequently Occasionally Never
I plan ahead of time how I am going to describe my problem. 5 4 3 2 1
I describe my most important problem first. 5 4 3 2 1
I check with my immediate family to determine if my problem runs in the family. 5 4 3 2 1
I take a list of medications, over-the-counter drugs, and treatments I am receiving. 5 4 3 2 1
Before the visit, I prepare a written list of questions to ask. 5 4 3 2 1
I ask about anything that is unclear to me. 5 4 3 2 1
I repeat in my own words the physician's answers to my questions. 5 4 3 2 1
I understand the doctor's diagnosis of my problem. 5 4 3 2 1
I make sure I know the benefits and risks of prescribed treatments. 5 4 3 2 1
I know if and when to return for a follow-up visit. 5 4 3 2 1
Scoring
46 - 50: Excellent communication
41 - 45: Good
36 - 40: Average
31 - 35: Fair
Less than 30: Poor