Patient Instructions (Medical Weight Management Care Plan)

(Patient-facing instructions for medical weight management. Write in second person, active voice, and everyday words. Avoid stigmatizing language; use terms like "weight management" and "weight-related health." Do not leave blanks or bracketed text in the final document. If key information is pending, write clear holding language such as "Your medication plan will be confirmed after we review your labs on March 10." Omit optional sections entirely if they do not apply. Keep the document concise enough to fit on one printed page.)

Patient Name: [Patient full name] (Omit this line if not available.)
Visit Date: [Full date with spelled-out month]
Clinic/Provider: [Clinic name and clinician name/credentials]
Clinic Phone: [Clinic phone number]
Visit Reason: [Plain-language reason, e.g., "Weight management follow-up"]

Your Top Priorities

(List 1–3 specific actions for the patient to focus on now. Each item must state what to do, how much/how often, and when to start. Write as direct, actionable instructions.)

• [Priority action with amount/frequency and start timing]
• [Additional priority action] (Include only if applicable; maximum 3 total.)

Your Care Plan

(Open with a brief sentence framing how this plan supports the patient's weight-related health goals.)

Nutrition: [Calorie target in kcal/day if set] (If no calorie goal was set, omit and focus on meal structure.) [Daily protein goal in grams if set.] [Meal structure approach discussed—e.g., plate method, protein-first, time-structured meals, meal replacements.] [2–4 practical examples in plain language.] [Hydration guidance and daily fluid target if discussed.]

Activity: [Aerobic goal in minutes/week or days/week with acceptable activities.] [Strength training frequency if recommended.] (Use "start here → progress to" format when building up gradually.) Start here: [initial manageable target]. → Progress to: [longer-term goal]. (Include safety note if starting a new program or if patient has relevant health conditions:) Stop and seek help if you have chest pain, severe shortness of breath, or fainting.

Medication: (Include this subsection only if a weight-management medication was started, changed, or stopped at this visit. Otherwise omit entirely.)

• Name and purpose: [Medication name] — you are taking this to support weight management by [plain-language mechanism].
• Dose and schedule: [Dose and route], [frequency/timing]. Start on [start date].
• How to take it: [With/without food; injection technique if applicable; storage if relevant.]
• Titration schedule: (If applicable, list week-by-week dose increases.)
  • [Week and corresponding dose/schedule for each step]
• Common side effects: [2–5 common effects in plain language].
• Serious warning signs: [Serious symptoms requiring immediate attention] — if these occur, call 911 or go to the ER.
• Missed dose: [Instructions] (Include only if explicitly confirmed.)
• (If prescription may be delayed due to insurance:) If your pharmacy cannot fill this, message us or call [Clinic phone number]. Do not pay out of pocket unless you choose to.

Tracking & Follow-Up

What to track: [List only items assigned—weight and frequency; food logs; activity minutes/steps; symptoms; blood pressure or glucose as applicable.]

Labs or tests: [Test name(s)] — [date or timeframe]. [Fasting requirement if any.] [Location.] (Include only if ordered.)

Referrals: [Referral type and provider/service]. [How scheduling will happen—clinic will call or patient will call.] (Include only if made.)

Next visit: [Date/time or interval]. [In person / video]. Bring: [logs, medication list, questions as applicable].

When to Contact Us

• Call 911 or go to the ER: Severe chest pain, trouble breathing, signs of a severe allergic reaction (swelling of face/lips/tongue, difficulty breathing), fainting, or any life-threatening emergency.
• Call our clinic today: Severe or persistent abdominal pain; ongoing vomiting or diarrhea causing dehydration; concerning mood changes possibly related to medication; or symptoms worsening quickly. Call [Clinic phone number].
• Message or call within 1–2 business days: Non-urgent questions about your plan, mild side effects that are not worsening, scheduling needs, or refills. Call [Clinic phone number] or use the patient portal.

(If no after-hours line exists, add: "If urgent after hours, go to urgent care or the emergency room.")