Six headings are usually enough. The list does not need to be polished — it needs to exist, in an order you can follow when you are tired.

• Main reason for this appointment

  One sentence if possible — the thing this appointment is actually for.

• What has changed?

  New symptoms, worse symptoms, or familiar symptoms behaving differently — with roughly when it started.

• How is this affecting daily life?

  Concrete examples of impact: standing, washing, meals, work or study, sleep, leaving home.

• What do I want to ask?

  Questions written down beforehand — including the one you most want answered.

• What information do I need to take?

  Medication and supplement list, any recent notes, test results or letters you have been sent.

• What would help me communicate?

  Whether you would like someone with you, written information instead of spoken, or extra processing time.

Each heading answers a question the clinician is likely to ask anyway — so writing it beforehand means the answer is ready rather than improvised under pressure.

What an appointment usually needs most is not a complete symptom inventory but a clear picture of what daily life currently looks like. Concrete examples do that better than general descriptions. Areas worth a line each, where relevant:

• Standing — how long is comfortable now, and what happens afterwards
• Washing and personal care — what has become harder, or needs help
• Preparing meals — what cooking now realistically looks like
• Work or study — hours, concentration, days missed
• Concentration — reading, following conversations, holding instructions
• Leaving home — how often, how far, what it costs in recovery
• Sleep — whether it restores anything, and how it has changed
• Communication — whether speaking or listening is more tiring than it was

One honest sentence per area is enough. This is not about proving anything — it is about giving an accurate picture, described plainly, so that it can be discussed properly.

Many people arrive with four or five concerns and ten minutes. Identifying the most important one or two beforehand — and putting those at the top of the list — means the essential things get said first. Not everything may fit into one appointment, and that is a normal feature of appointments rather than a personal failing. The remaining concerns can stay on the list for a follow-up, or be sent as a written question to the practice afterwards, which is an ordinary thing to do.

The best format is whichever one survives contact with the day itself:

• One page of notes, or one card — short enough to glance at rather than read
• Bullet points rather than paragraphs; single words where a sentence is too much
• Printing the notes, if a screen is difficult on the day
• Showing the written notes directly — handing them over at the start and saying “this is what I wanted to cover” is a completely legitimate way to run an appointment
• Asking someone to come with you — a partner, friend or carer can hold a copy, take in what is said, and ask the questions you have written down
• Asking for written follow-up — requesting the summary or plan in writing afterwards, so nothing has to be remembered on the spot

None of these are workarounds for a failing memory; they are how people with limited cognitive capacity routinely get better outcomes from ten minutes than improvisation would.

Two categories of practical preparation sit outside the notes themselves. Access needs are worth sorting in advance: whether waiting can happen somewhere quiet, whether a lower-light room is possible, whether stairs are avoidable, whether the appointment can be first on the list or by phone where appropriate. Communication needs can be stated in the appointment itself — asking for one thing at a time, or for information to be written down, is a reasonable request to make.

And the appointment is a pacing event: getting ready, travel, the waiting room and the journey home are all capacity spend, and the day needs slack around them. A quiet morning before, a rest booked after, transport planned rather than improvised — the appointment is rarely just the appointment. The Leaving the House page covers this in more detail.

When capacity is very low, the preparation may need to be done mostly or entirely by someone else — a partner or carer writing the list from what you tell them, on a day when telling them is possible, and reading it out in the appointment. Remote and telephone appointments can remove the travel entirely, which for some people makes the difference between attending and not attending. If speaking at all is difficult on the day, a written list sent to the clinician beforehand, and a supporter holding a copy, means your information still reaches the room even when your voice cannot.