___ 4. Past Medical History:  Note ALL major illnesses, hospital admissions, and surgeries, major and minor, implanted devices, and no matter how far back in time. Give the dates.


___ 5. Family History: You may be asked about any chronic illness or cancer in your family.


___ 6. Social History: Life style issues such as cigarette smoking, alcohol consumption, obesity, use of illegal drugs, may impact your response to treatment. Co-morbidities often have to be addressed before a successful outcome can be achieved.


___ 7. Medications:  Provide a list of ALL your medications including, dosage, how taken, and for what reason.  Vitamins, supplements, over the counter, and non-prescription must also be listed.  Mention all your allergies.


___ 8. Imaging Studies: Bring the reports and the actual pictures or CD of any X-rays, CT scan, MRI, ultrasound, which you may have in your possession.


___ 9. Questions: Make a list of the most important questions that you have, and do not forget to ask them


___ 10. Expectations:  Be certain about your expectations, and make sure that you communicate this to your healthcare provider. You should be told what is realistic, and what is not.  Remember that doctors do not create immortality!


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