Patient Instructions (Herbal Medicine Plan)

Patient Instructions: Herbal Medicine Plan

Date: [Date]

Clinic/Practice: [Clinic or practice name]

Daytime phone: [Primary phone number]

After-hours phone: [After-hours phone number] (Only include if available)

Clinician: [Clinician name and credentials] (Optional)

(Use second person voice throughout. Use short, plain-language sentences. Use numerals for all quantities. Spell out units the first time with abbreviations in parentheses, e.g., milliliters (mL), teaspoons (tsp). Avoid unsafe abbreviations: qd, QD, qod, U, IU. No trailing zeros; use leading zeros for decimals.)

This handout supports your care. It does not replace emergency care. (Optional disclaimer)

Main Message

[Core action: start / continue / stop] [most important product(s)] [timeframe or duration]. Stop and seek care if you have [key warning symptom(s), e.g., rash, swelling, or trouble breathing].

(Write 1–3 bolded sentences naming the action, key product(s), timeframe, and a clear stop-and-seek-care warning. If no herbal regimen is prescribed, write exactly: "No herbal medicine was started today. Continue your current plan unless your clinician told you otherwise." Then omit all sections below.)

Your Herbal Regimen

(Create a separate product card for each herbal product. Do not infer dosing or preparation. If any safety-critical detail is missing—dose, timing, or duration—insert the hard-stop line shown below.)

[Product name (common name; botanical name in parentheses only if needed for clarity)]

• Form/route: [capsule / tea / tincture / powder / topical / other]
• Purpose: [Plain-language purpose in one short line]
• Dose: [Amount] [unit] [per dose], [number of times per day] (Do not infer)
• When to take: [Time(s) of day anchored to clock or routine] [with food / on empty stomach / no food guidance]
• How long to take: [Duration in days or weeks]
• If you miss a dose: [Simple instruction, e.g., take it when you remember unless close to the next dose; do not double up]
• Brand/strength: [Brand and strength per unit] (Only include if known)
• Tincture details: [Alcohol content %] (Only include for tinctures when known)
• Preparation/use: [Concise steps for tea, decoction, powder, tincture dilution, or topical application] (If steps were not provided, write: "Preparation instructions were not provided—contact the clinic before starting.")

(Repeat the product card structure above for each additional product.)

If any dose, timing, or duration is missing or unclear for any product above, include: "Do not start until clarified—contact the clinic."

What to Expect & Possible Side Effects

When you may notice effects: [Estimated range in days or weeks] (Avoid guarantees)

Normal short-term effects: [Mild, temporary effects that may occur and usually pass]

Self-monitoring: [What to track, e.g., sleep, bowel pattern, pain level, mood, or skin changes] (Only include if relevant)

Common side effects: [List in plain language]. If mild, you may continue. If bothersome, try adjusting timing (e.g., take with food or earlier in the day). If they persist or worsen, call us.

(If the side effect profile is unknown, include: "Herbal products can cause side effects. If you develop new or concerning symptoms after starting, stop the product and contact us.")

When to Get Help

Emergency (call 911 or go to the ER):

• Trouble breathing or swelling of your lips, tongue, or throat
• Severe chest pain or fainting
• Signs of severe bleeding (vomiting blood, black or tarry stools)
• Severe confusion or a seizure

Call the clinic same day:

• New rash
• Persistent vomiting or diarrhea
• Yellow skin or eyes, or dark urine
• Palpitations (racing, skipped, or pounding heartbeat)
• Any concerning symptom that begins soon after starting the herb

Important Safety Notes & Follow-Up

• Tell all your healthcare providers and pharmacists about every herb and supplement you take. Bring your bottles or labels to visits.
• Herbal products can interact with medicines including blood thinners, antidepressants, immunosuppressants, HIV medications, seizure medications, diabetes medications, digoxin, and oral contraceptives. If you take any of these, check with our team before starting or changing an herb.
• Before any planned surgery or dental procedure, tell the surgical or dental team about your herb use.
• If you are pregnant, trying to conceive, or breastfeeding, check with us before starting. (Include if pregnancy/breastfeeding status is unknown or relevant)
• Follow-up: [Next appointment date and time] or [Timeframe to check in, e.g., "in 2 weeks"] (If not scheduled, write: "Call to schedule a follow-up appointment.")
• What to track or bring: [Symptoms or measures to monitor], herb bottles or labels, any questions or side effects you noticed
• How to reach us: [Daytime phone], [After-hours phone if available], [Secure message or portal if applicable]

(Omit entire sections that do not apply or when no regimen was started. If any safety-critical detail is missing—dose, timing, duration, or key warning—insert: "Do not start until clarified—contact the clinic.")