Testing Checklist

For Your Doctor's Appointment

Patient Name:

Appointment Date:

Time:

Doctor/Provider:

Reason for Visit:

📋 Instructions:
Check the boxes next to tests you want to request based on your symptoms. Bring this completed checklist to your appointment to ensure you don't forget to ask for important tests.

How to Use This Checklist

Step 1: Check your symptoms on page 2
Step 2: Select relevant tests on pages 3-4 based on your symptoms
Step 3: Use the scripts on page 5 to request testing
Step 4: Take notes during your appointment on page 6

💡 Pro Tips:

Bring past test results if you have them
Note when your last period started (for hormone timing)
Write down your top 3-4 symptoms before the appointment
Request a copy of your results with actual numbers

STEP 1: Check Your Symptoms

Select all symptoms you're experiencing. This helps determine which tests to request.

Menstrual & Reproductive

Irregular cycles (more than 35 days apart or fewer than 8 periods per year)

Very heavy bleeding (soaking through pad/tampon in less than 2 hours)

Severe menstrual pain that interferes with daily activities

Pain during or after sex (dyspareunia)

Difficulty conceiving after 6-12 months of trying

Hormonal Signs

Acne (especially on jawline, chest, or back)

Excess hair growth (face, chest, abdomen, back - hirsutism)

Hair thinning or hair loss on scalp

Weight gain (especially around middle/abdomen)

Difficulty losing weight despite diet and exercise

Energy & Mood

Chronic fatigue that doesn't improve with rest

Depression or persistent sadness

Anxiety or panic attacks

Severe mood swings

Mood symptoms that worsen dramatically before period

Difficulty concentrating (brain fog)

Physical Symptoms

Hot flashes or night sweats

Sleep problems (difficulty falling asleep or staying asleep)

Heart palpitations or rapid heartbeat

Unexplained weight changes

Always feeling cold (cold intolerance)

Constipation or digestive issues

Dry skin, brittle nails

When Do Symptoms Occur?

All month long (consistent)

Only during menstruation (Days 1-7)

Only before period (Days 21-28 / luteal phase)

Worsening over time

Started after:

Severity & Impact

Severity (circle one): Mild | Moderate | Severe | Debilitating

Impact on Daily Life:

Missing work or school

Avoiding social activities

Unable to exercise

Relationship problems

Affecting mental health

STEP 2: Select Tests Based on Your Symptoms

IF YOU SUSPECT: PCOS

Common symptoms: Irregular cycles, acne, excess hair growth, weight gain

🔴 Essential Tests:

Total Testosterone

LH (Luteinizing Hormone) - Day 3

FSH (Follicle Stimulating Hormone) - Day 3

Fasting Glucose OR HbA1c

🟡 Recommended Tests:

Free Testosterone

DHEA-S

Fasting Insulin

Lipid Panel (Cholesterol, Triglycerides)

When to test: Days 2-5 of cycle for hormones | Fasting required: Yes, for glucose and insulin

IF YOU SUSPECT: THYROID ISSUES

Common symptoms: Fatigue, weight changes, hair loss, feeling cold, mood changes

🔴 Essential Tests:

TSH (Thyroid Stimulating Hormone)

Free T4

Free T3

🟡 Recommended Tests:

Reverse T3 (if conversion issues suspected)

TPO Antibodies (Thyroid Peroxidase)

Thyroglobulin Antibodies

When to test: Morning, before taking thyroid medication | Fasting required: No, but preferred

IF YOU SUSPECT: PERIMENOPAUSE

Common symptoms: Age 40+, irregular cycles, hot flashes, mood changes, sleep issues

FSH (Follicle Stimulating Hormone)

Estradiol (E2)

AMH (Anti-Müllerian Hormone)

⚠️ Important: Single hormone tests are often unhelpful because levels fluctuate wildly during perimenopause. Perimenopause is primarily diagnosed based on symptoms + age (40-55). Testing can support diagnosis but shouldn't override obvious symptoms.

When to test: Day 3 of cycle (if still cycling regularly)

IF YOU SUSPECT: ENDOMETRIOSIS

Common symptoms: Severe period pain, pain with sex, heavy bleeding, chronic pelvic pain

Pelvic Ultrasound (imaging)

CA-125 blood test (may be elevated, but not diagnostic)

MRI (if deep infiltrating disease suspected)

⚠️ Critical to understand: No blood test can diagnose endometriosis. Imaging can identify some cases, but laparoscopy with biopsy is the gold standard. However, many doctors now treat symptomatically without surgery (hormonal suppression, pain management).

IF YOU SUSPECT: PMDD

Common symptoms: Severe mood symptoms 1-2 weeks before period (anxiety, depression, irritability)

Tests to Rule Out Other Causes:

Thyroid panel (TSH, Free T3, Free T4)

CBC (Complete Blood Count - rule out anemia)

Note: PMDD is a clinical diagnosis based on symptom timing. No blood test confirms it. Track symptoms for 2 cycles to show the pattern (symptoms in luteal phase, relief with menstruation).

General Screening Tests

Consider requesting these alongside condition-specific testing to rule out common issues:

Complete Blood Count (CBC) - Screens for anemia, infection, blood disorders

Comprehensive Metabolic Panel (CMP) - Kidney/liver function, electrolytes, blood sugar

Vitamin D - Deficiency common, affects mood, bone health, immune function

Vitamin B12 - Deficiency causes fatigue, mood changes, neurological symptoms

Iron Panel (Ferritin, TIBC, Serum Iron) - Low iron causes fatigue, hair loss

STEP 3: How to Request Testing

Opening Script

"Based on my symptoms of [list your top 3-4 symptoms], I'm concerned about [condition]. I'd like to request testing to either confirm this or rule it out. Can we order [list specific tests from your checklist]?"

If Doctor Says "Let's Wait and See"

"I've been experiencing these symptoms for [length of time] and they're significantly impacting my quality of life. I'd like baseline testing now so we have numbers to compare if symptoms worsen. What's your concern about testing at this point?"

If Doctor Refuses Without Explanation

"Can you help me understand why you don't think this testing is necessary? I want to make sure we're ruling out medical causes before attributing my symptoms to stress or lifestyle factors."

If You Still Get Pushback

"I'd like this documented in my chart: that I requested testing for [condition] and it was declined. Can you note that, please?"

If your doctor still refuses without good reason, consider getting a second opinion or finding a new provider who will listen to your concerns.

After Testing: Getting Your Results

Always do these things:

Request a copy of your actual results with numbers, not just "everything's normal"

Ask where you fall within the reference range (low end, middle, or high end)

Ask if your provider considers the results optimal or just acceptable

Get a printed copy or save electronic copy from patient portal

If results are borderline, ask whether treatment or monitoring is appropriate

Key Questions to Ask About Your Results

❶ "Where do I fall within the reference range? Am I at the low end, middle, or high end?"

❷ "Do you think this result is optimal, or just within normal range?"

❸ "How do these results compare to my previous tests?"

❹ "Given my symptoms, are there any additional tests we should consider?"

❺ "What's our plan if symptoms continue despite normal results?"

STEP 4: Appointment Notes

My Questions for the Doctor

1.

2.

3.

4.

5.

Tests Ordered Today

When to get tested:
Fasting required?	☐ Yes ☐ No
Cycle day to test (if applicable):

Follow-Up Plan

Results will be ready:
How to access results:
Follow-up appointment:

Next Steps & Treatment Discussion

📸 Pro Tip: Take photos of your lab results with your phone, or request electronic copies through your patient portal. This makes it easy to reference past results and share with new providers or specialists.