This resource is to help you communicate your needs and preferences to doctors and clinicians who are caring for you. It has been written specifically for people living with both physical and mental health concerns. The resource is designed to be used in appointments with General Practitioners (GPs) but may also be used in any other care setting.

You can use this resource to help identify your health needs, and work out what matters most to you before you go to appointments. You might do this just as a record for yourself, or you might complete this resource to give it to your doctor or specialist, clinician, or support person. You can print this out before you go to your appointment.

The resource contains about 40 questions. You don't need to answer every question, only the ones you want to share. It will take at least 20 minutes to complete, but may take longer depending on the information you would you like to include.

When you have filled out all you want to share, it can be saved as a PDF file or printed. The questions you don't answer will not be included in the PDF. You could also download a blank version of the resource as a Word document. Using the Word version might make it easier:

• If you want to share different information with different clinicians.
• If you think your needs will change.
• If you think it will need updating.
• If you don't think you will finish it in one sitting, as the web version won't save your progress if you leave the webpage.

It will have all the questions on it and if you think of something else you would like to add, you can.

This resource was made in 2023-2024 using a co-design process. This means that it was designed by a group made up of:

• People living with experiences of mental health concerns and physical health concerns; and
• Lived experience researchers.

The group had members from all over Australia and worked together to decide what would be in it. They made decisions together about what the resource would include. While research was used to create this resource, none of your information is being collected when you use this resource.

We have tried to make this resource as empowering and useful as possible. We have chosen to use the phrase “people with physical and mental health concerns” rather than defining people by diagnoses or illnesses. The group tried to make this as helpful as possible, so that you could speak up about things that matter to you and have your needs met.

We hope this is useful and we'd like to hear from you if it is. If it is not helpful for you let us know and we will do our best improve it. You can provide feedback at enquiries@equallywell.org.au.

Every state and territory in Australia has different laws about your rights. We have added some links with information to help you use your rights. You can read more in the Helpful Links.

What is your name?

Is there any other introductory information that you would like your doctor to know about you?

You may like to include identity characteristics such as your gender, age, sexuality, ethnicity.

You may also like to include important things for your heath needs, such as the preferred/required gender of a clinician who will interact with you, and cost-related issues/financial stress (and if you have a pension, concession, or other card that may be related to payment).

Your medical history and relevant health information:

Here, you might like to list your health diagnoses, previous surgeries, main health concerns, past treatments you've had and your perspectives on them.

Any information relevant to your health care:

Here, you might like to list any concerns not outlined above, including barriers to care or any past treatments that you've tried and your perspectives on them

Are there things that help you to feel safe/able to speak up?

This might include:

Check the boxes you would like to include in your plan and add any additional information.

• Being asked questions
• Having time to ask questions
• Being able to book a longer appointment
• Having florescent lights turned off
• Having a support person come along
• Having time to make decisions
• Trauma informed care
• Being talked through everything step by step
• Having any recommendations or instructions written down
• Making an agreement on further steps that might happen after the appointment
• Having a lot (or a little) information about my health
• Knowing where to go to get information

Are there things that make you to feel unsafe?

This might include not being asked how you feel about a treatment recommendation, being touched without warning/consent, not being consulted regarding health diagnoses.

When you are unwell, what do you need people to know?

This is where you can record any differences in how you experience the world when you're unwell. You might like to include things like speaking pace, changes in readiness to make decisions, and willingness to attend appointments. You might also like to include responses from others that you have found helpful in the past.

When you are well, what would you like to happen?

Anything you'd like to focus on when you are feeling well, such as being prompted routine health checks, preventative care, improving diet, things to increase wellbeing, long-term health management strategies, links to longer-term services etc.

Is there anything else your clinicians should know about you?

Anything important that you haven't covered above.

Physical health priorities

What are your physical health priorities?
Check the boxes you would like to include in your plan.

• Balanced nutrition
• Contraception
• Develop/Review current care plan
• Digestive health
• Exercise
• Fertility
• Medication
• Pain management
• Regular health check-ups
• Regular screenings and tests (cervical, bowel, prostate, diabetes, metabolic syndrome etc)
• Sexual health
• Skin health
• Sleep health
• Smoking
• Stress management
• Substance use
• Weight management
• Work-life balance

Would you like to add any other physical health priorities?

Identifying Support Persons

Many people prefer to have a support person with them, but you don't have to have a supporter.

The key advantages of bringing a support person are that they can note down what the clinician says, in case you forget later, and they might help you feel more confident expressing your needs.

Here, you can make a list of people who support you and their contact information for your own reference. You might also like to note other information, like what they can help you with.

Who are the people that support you?

Social and Emotional Wellbeing

In addition to considering your physical and mental health, you might also want support for your social and emotional wellbeing. Unfortunately, this goes beyond the scope of what a GP can usually provide, but they might be able to refer you to another service that can assist you with these health needs. Alternatively, you might like to discuss these needs with an allied health worker who might be better positioned to help you meet these health needs.

What social and emotional wellbeing needs would you like support with?
Check the boxes you would like to include in your plan.

• Anxiety or Depression
• Autonomy and Control
• Belonging and Connection
• Community and Inclusion
• Empathy and Understanding
• Friendship and Companionship
• Purpose and Meaning
• Relationship challenges
• Safety and Security
• Self-Esteem and Confidence
• Self-Expression and Creativity
• Support and Encouragement
• Validation and Acceptance

Are there any other social and emotional wellbeing needs that you would like support with?

In this section, you can decide what you might like to talk about in the appointment.

Is there anything else you would like to discuss in your appointments?

Medication

In this section, you can focus specifically on your medications and their effects.

The list below outlines some topics or questions you might like to discuss with your doctor. You can also put in your own:

Check the boxes you would like to include in your plan.

• Impact on Daily Life
  Discuss how the medication affects their daily activities, work, sleep, and overall quality of life.
• Symptom Management
  Discuss how the medication is affecting their symptoms, including any improvements or worsening of symptoms since starting the medication.
• Side Effects
  Inquire about any current or potential side effects experienced and whether they are common or worrisome.
• Withdrawal Effects
  For medications that might cause dependency or withdrawal symptoms, discuss the proper method of tapering off and any precautions.
• Medication Adjustments
  Ask if the dosage needs to be adjusted or if there are alternative medications that might be more suitable or have fewer side effects.
• Interactions
  Discuss any interactions between the prescribed medication and other medications, supplements, or substances you are using.
• Long-Term Effects
  Inquire about the long-term effects of the medication and any concerns about dependency or tolerance.
• Expectations
  Clarify realistic expectations about the timeline for improvement or potential changes in based on your currently prescribed medications.
• Monitoring
  Inquire about the need for regular check-ins or monitoring to assess the effectiveness and safety of the medication.
• Alternative Treatments
  Ask about alternative treatments or therapies that could complement or substitute for medication.

Are there any other topics or questions related to medication that you might like to discuss with your doctor?

In this section, you can prepare the steps you would like to take after your appointment.

You can include and expand on the suggested steps and categories below, or write your own.

These are some state and national links to health resources, including health advocacy resources, you might find useful.

Include Memorandum of Understanding for your doctor to sign that reads: