Version of 25 September 2026. If your printout carries an earlier date, check what changed before relying on it.
A demonstration of the kit with an invented person: the records and the words on these pages were made up. It is not medical advice and it decides nothing. Nothing typed into these pages leaves this browser, and on this copy Send goes nowhere.
The person who made these pages is a care systems liaison: they work on the records and the questions, and the clinicians named in these pages do the medicine. Nothing here is medical advice: no diagnosis, no treatment advice, no medicine changes. They help you gather your own records, put your own history in one place, write down the questions you want answered, and prepare one page to hand to each clinician. They do not call your clinicians or sit in your appointments; the kit is built so that you do. They work for you, not for any hospital, insurer or doctor (the scope the field certifies as independent patient advocacy). Where AI tools were used to organise or review material, your names were removed first, the pages say what came from where, and those tools are not medical advice either. Everything here is yours: you decide what goes to whom, and you can have all of it back or deleted at any time.
This kit is for visits, not emergencies. A fall with a knock to the head, new confusion, chest pain, trouble breathing, or a reading past the number your clinician gave you (the sitting number the practice wrote on her card): call the clinic today, or the emergency number.
Written with AI, and read against the records. In a real kit these pages are drafted and drawn with AI from the records they cite and the family's own words, and every page is then read against those records by the person who made it. On this demonstration there are no records: every name, date, medicine and reading was made up. The records a real kit cites can themselves be wrong or out of date, and only that person's clinicians can tell them so. Nothing here is medical advice, and nothing here decides anything.
Written with AI, read against the records. In a real kit; on this demonstration the person and the records were made up. The full note is under Who made this.
This is a demonstration of the kit with an invented person, Marguerite. Every name, date, medicine, reading and letter on these pages was made up; nothing here is about anyone real, and nothing here is a record a clinician has seen. The kit is made by a care systems liaison, who works on the records and the questions while the clinicians do the medicine: no diagnosis, no treatment advice, no medicine changes. A kit for a real person carries no names.
Every document that might be sent or handed over, ready to fill in right here: click into any of them and type over the blanks. Highlight text and use the small toolbar on each document for bold, italics, underline, and lists. Then download it as a Word file, or use Print to save a clean PDF; your formatting comes with it. Downloads come out as plain professional letters with no web styling.
Sending goes to a private form, you see what is being sent before it goes, and nothing leaves this device until you press the button.
Collects everything you have changed here and carries it to a private send form; you review it before anything goes.savedThe care team, one line each, entered once: every document below fills the right names into the right places. Leave anything blank to keep the plain line. Like all edits, these save only in this browser. The pharmacy call-around script stays name-free on purpose.
Goal number one, in the patient's own words: ______________________________________
Nothing else is a real conversation until that one is moving. We ask every clinician to measure each proposed step against it first: does this serve the goal, or at least not work against it?
While that is being worked on, these must not be lost:
1. ______________________________________
2. ______________________________________
3. ______________________________________
If things go better than expected, the next thing we would want is: ______________________________________
Write the first goal in the patient's words, not the family's and not a clinician's. Bring a copy to every consult. It is the input the whole plan answers to.
To the medical records office, regarding ______________, date of birth ______________.
We are requesting copies of the following records, on paper or as a portal download, within the time your policy allows:
1. The most recent clinic note and problem list.
2. Every test result from the last two years (imaging reports, laboratory results, nerve or heart studies), with the report text and not only the summary line.
3. Operative reports and discharge summaries for any admission.
4. The current medication list as your office holds it.
Please send to ______________ at ______________, or tell us what form your office needs signed.
Thank you.
Retrieve before you reason: one records-release form per office answers half the questions before any new test is ordered. Keep a list of what was asked for, when, and what came back.
To the primary care office, attention ______________, regarding ______________, date of birth ______________.
We are writing to ask for the following, in writing where possible:
1. One current list of every clinician involved and what each is following, so the family holds the same list the office does.
2. A reconciled medication list, checked against the bottles we bring.
3. Retrieval of the results listed on the attached page before any new test is ordered.
4. Your view on which one question, of the ones attached, matters most this month, and who should answer it.
Thank you. ______________ can be reached at ______________.
Split into two messages if the portal has a length limit. Attach the retrieve list from the order set and the printed one-pager.
To ______________, regarding ______________, date of birth ______________.
Ahead of the appointment, we are sending one page: the history as the family holds it, the medicines as taken, the results we have already retrieved, and the three questions we most want answered. We are not asking for anything to be decided in advance; we are asking that the visit start from the record instead of from memory.
The one thing the family is most afraid of about this visit: ______________________________________
Our three questions, in order:
1. ______________________________________
2. ______________________________________
3. ______________________________________
Thank you.
Copy this once per specialist and change the name. One page, sent a week ahead, is read; a folder is not.
To: ______________
Thank you for seeing ______________. We are asking for an independent read of ______________________________________. Our questions, in order:
1. Enclosed are the original reports. Given what they actually say, is the current picture the expected course, or something that needs a different explanation?
2. What single test or result, if any, would most change your view?
3. What would you want the treating clinician to know from this visit, in one sentence?
Enclosed: ______________________________________
If a report cannot be obtained in time, say so on the cover sheet; requesting it is one records-release form.
Emergency and hospital events for ______________, per family record. Goes in every packet.
| Date | Where | What was written as the reason | What was found | What changed after |
|---|---|---|---|---|
| ______ | ______ | ______ | ______ | ______ |
| ______ | ______ | ______ | ______ | ______ |
| ______ | ______ | ______ | ______ | ______ |
Six visits read one at a time are six isolated visits; the same six on one page are a pattern. Fill it from the discharge papers and the calendar, not from memory.
"Hello, I am calling for a family member. Before I transfer a prescription, could you tell me whether you usually stock ______________________________________ at the ______ dose, and whether you would fill it on a regular schedule if the prescriber sends it? I do not need to give a name today; I am checking which pharmacy can carry it."
Pharmacy: ______ Date: ______ Answer: ______ Person spoken to: ______
Stays name-free on purpose. Call three; write down each answer.
Medication list for ______________, date of birth ______________. Updated (date): ______
| Medication | Dose | Times per day | Prescriber | Pharmacy | What it is for (family's words) |
|---|---|---|---|---|---|
| ______ | ______ | ______ | ______ | ______ | ______ |
| ______ | ______ | ______ | ______ | ______ | ______ |
| ______ | ______ | ______ | ______ | ______ | ______ |
| ______ | ______ | ______ | ______ | ______ | ______ |
| ______ | ______ | ______ | ______ | ______ | ______ |
| ______ | ______ | ______ | ______ | ______ | ______ |
Over the counter, supplements, caffeine, alcohol, cannabis: ______________________________________
One page, every appointment, updated the day any dose changes. Built from the bottles, not from the chart.
A demonstration kit. The method and the tools are real; the person is invented.