Questions for my next visit
Bring this page to your doctor. Use your browser's Print button to print it.
Mary · Prepared Tuesday, September 29, 2026
- My plan is still deciding about Repatha. Your office sent the request on September 28. Does the plan need anything else from you?
- My plan said no to Vascepa in a letter dated September 22. Can we ask the plan to look again? The last day to ask is November 26.
- Is my medicine list below correct?
- Who can help me understand what my medicines will cost?
- My own question: ______________________________
My medicine list
| Medicine | Last filled |
|---|---|
| Entresto (sacubitril and valsartan) | Thursday, September 3, 2026 |
| Repatha (evolocumab) | Not filled yet |
| Farxiga (dapagliflozin) | Monday, September 21, 2026 |
| Eliquis (apixaban) | Saturday, September 12, 2026 |
| Atorvastatin (atorvastatin) | Tuesday, September 1, 2026 |
| Vascepa (icosapent ethyl) | Not filled yet |
Prepared from sample information. FuzzMed gives information, not medical advice.