Consultation Second Opinion Checklist

Please Bring With You:

• List of questions for me

• My medical history form - please complete this form, even if the information is included in the medical records
• Copies of medical records, including surgical (operative) and pathology reports, discharge summaries, consultations, x-ray and scan reports, and records of previous treatment
• Actual x-ray films, CT, MRI, ultrasound images, and other scans (not just the reports)
• Reports of recent blood tests
• List of medications you are taking
• Reports of radiation therapy and chemotherapy
• Pathology slides
• Reports of recent treatment, evaluations, blood tests, and x-rays/scans
• Detailed reports from any other treatments
• Reports of therapy with other drugs or biological therapy
• Any other pertinent records
• Insurance forms and cards
• Business cards or name and address list from your current/referring doctor(s)
• Notepad, pens, and (if you wish) a tape recorder to record your visit.
• Please bring Xerox copies of your records, so I can keep them for my file on your case

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