Take Control of Your Healthcare Story — One Page at a Time
No more blank stares when a doctor asks for your history.
Fill it out once & have it ready for every appointment, anytime you need it!
Your health story matters—and it deserves to be told clearly, fully, and with confidence.
This FREE printable Health History Template helps you organize all the key info doctors need, so you never have to scramble mid-appointment again.
This fillable, easy-to-use PDF template provides you with:
A Comprehensive Health Overview
Track medications, past medical history, insurance info, and more in one easy-to-use document.
An Appointment Prep Section
Stay organized, remember key concerns, and ask the right questions during your visits.
Bonus: Lifestyle & Mental Health Tracking
Because your whole health matters, not just your symptoms.
Why it matters:
Having your health history ready can speed up diagnosis, avoid miscommunications, and make sure you get the care you actually need—not just what fits into a rushed appointment.
Your health is important—make sure you’re in control.
Whether you have a chronic condition, manage family healthcare, or just want to stay organized—this template is for you.
How It Works:
Sign Up Below with your email
Get Instant Access to your FREE Health History Template
Download & Fill Out digitally or print it for easy reference
**Your health information is personal—and your privacy matters. I’ll never spam you or share your info. Just helpful, empowering resources straight to your inbox.
Download now & show up to your next appointment prepared and powerful.
Psst… heads up!
By grabbing this freebie, you’ll be added to my email list—but don’t worry, I don’t do spam and I definitely don’t do boring.
Here’s what you can expect:
💌 Occasional emails (generally 1-2/week) packed with helpful, real-talk healthcare tips
📣 Heads up on new tools, resources & juicy updates
🧠 Support to help you become your own best advocate
💸 A heads-up when I drop discounts on paid guides & courses
I promise to respect your inbox and only send things that make your life easier, not more cluttered. You can unsubscribe anytime (but I hope you’ll stick around because I think we’ll be great together).
About The Audacious Patient
Hey, I’m Mallory —
Founder of The Audacious Patient: part movement, part resource, and part reclamation for anyone who’s ever felt dismissed, disempowered, or gaslit by the healthcare system—or any system, really.
I blend emotional intelligence, strategy, and soul to help people advocate for themselves without shrinking.
I’m not here to play nice—I’m here to help you get what you need without apology. Think sacred punk auntie meets trauma-informed strategist.
This work is about sovereignty, self-advocacy, and creating safety on your own terms—inside and out.
My mission is to help you cut through the fear, the red tape, and the shame—and take back your power in the exam room, at the billing desk, and everywhere in between.
Need help?
Don't worry, I got you. Here are some answers for your questions.
Anyone! Whether you're managing chronic conditions, keeping track of family health, or just want to stay organized for doctor’s visits, this template is designed to simplify healthcare for everyone.
Yes, it’s 100% free—no strings attached. All you have to do is enter your email address to download it. You’ll also get occasional helpful tips and resources to support you in becoming your own health advocate, but you can unsubscribe anytime.
You can fill it out digitally on your computer, tablet, or phone, or print it for handwritten notes. It's designed to be flexible and easy to update whenever your health information changes.
Absolutely. I don’t collect or store any of your personal health information. The template is for your personal use only, and your email is safe with me—no spam, ever.
I recommend updating it whenever there's a change in your health and treatments—like a new diagnosis, medication, or doctor’s appointment. Regular updates will help you stay prepared.
Since I don’t store your information, I recommend saving a copy to a secure location like your computer, cloud storage, or an external drive. You can always download a fresh copy if needed.
I’d be surprised if you didn’t find it useful, but if that happens, I’d love to hear your feedback so I can improve future resources. You’re also welcome to unsubscribe from emails at any time—no hard feelings.
Have the Audacity.
You're Worth It.
Join the Audacious Inner Circle — where the learning (and unlearning) never stops.
© 2024 The Audacious Patient. All rights reserved.
