Multiple Sclerosis: Doctor Discussion Guide

This Doctor Discussion Guide will help you talk to your doctor about your MS treatment. Just fill in the blanks, and then use the buttons at the bottom of the screen to print your results. Or you can show your results on your mobile device during your visit to the doctor's office.

My MS Treatment History

This information will help your doctor understand your treatment history and decide on the best choice for you.

I am currently using:

Since starting my current treatment for MS, I have had:

Issues I have with my current MS treatment (please select all that applies):

I have previously tried:

Issues I experienced with my past MS treatment (please select all that applies):

I prefer MS treatments that are (please select all that applies):

I am currently using:

    Since starting my current treatment for MS, I have had:

      Issues I have with my current MS treatment (please select all that applies):

        I have previously tried:

          Issues I experienced with my past MS treatment (please select all that applies):

            I prefer MS treatments that are (please select all that applies):

              My questions about MS

              This information will help your doctor fill you in on potential knowledge gaps and address your concerns. Check off all questions that you would like to ask your doctor about MS.

              General questions about MS (please check off all the questions you'd like to ask):

              My MS treatment questions (please check off all the questions you'd like to ask):

              General questions about MS (please check off all the questions you'd like to ask):

                My MS treatment questions (please check off all the questions you'd like to ask):

                  My results

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                  NPR/GILE/0035 E