Get Ready for a Shared Decision With One Simple Worksheet
You can prepare for a healthcare decision in three parts: name your options, list the questions you need answered, and write down what matters most to you. This page gives you a plain worksheet for all three, based on the shared decision-making framework used by the Agency for Healthcare Research and Quality (AHRQ). If your situation feels urgent or unsafe, contact your care team or local emergency services first — this page is for planning ahead of a scheduled conversation, not for emergencies.
What “Shared Decision-Making” Actually Means
Shared decision-making is a process in which you and your clinician work together, combining medical evidence with your goals and preferences, rather than one side deciding alone. AHRQ describes this as a dialogue in which the clinician and patient explore the benefits, harms, and risks of each option and discuss what matters most to the patient. That framework is called the SHARE Approach, and it breaks the process into a few clear steps: identifying that a decision needs to be made, exploring and comparing the reasonable options, weighing values and preferences, reaching a decision together, and reviewing it afterward.
The worksheet below turns those same steps into questions and prompts you can fill out before your visit.
Evidence Ladder: What’s Known, What’s Guidance, and What’s Still Uncertain
Not every fact about a healthcare decision carries the same weight. Sorting information into these three levels before your visit helps you ask sharper questions.
- Established evidence: Findings that are well-supported and used broadly in patient care, such as general descriptions of how a condition or option is expected to behave in most people.
- Professional guidance: Recommendations from health organizations or clinical practice that apply established evidence to a general population, but still need to be adjusted to your specific situation by your care team.
- Open uncertainty: Questions the current evidence cannot fully answer, such as how a treatment might affect someone with your exact combination of conditions, preferences, or life circumstances.
Write down, in your own words, one thing you believe falls into each level for your decision. If you’re unsure which level something belongs in, that uncertainty itself is a good question to bring to your visit.
Step 1: Name Every Reasonable Option
A decision usually involves more than one path — sometimes including the option to wait or gather more information first. Before your visit, write down every option you already know about, then plan to ask your clinician to confirm the full list.
- What are all the reasonable options for my situation?
- Is watching and waiting a real option here, or not?
- Is there a time limit on making this decision?
- What would need to be true for one option to be ruled out?
Step 2: Compare Benefit, Harm, Burden, and Uncertainty
For each option, four different questions matter: What might it improve (benefit)? What could it cause that you don’t want (harm)? What will it ask of your time, money, or daily routine (burden)? And what does the evidence not yet tell us (uncertainty)? Use a simple worksheet like this for each option you’re weighing:
- Option: ____
- Possible benefit: ____
- Possible harm: ____
- Daily-life burden: ____
- What’s uncertain: ____
If your clinician gives you a number — like a percentage change in risk — ask what time period it covers and what it means for a group of people like you. A risk described as “cut in half” means something very different depending on the starting numbers.
Step 3: Put Your Priorities in Writing
Your care team can only weigh a priority they know about. Before your visit, finish this sentence for yourself:
“I am deciding whether to ____ because ____. The outcome that matters most to me is ____. The uncertainty I most need explained is ____.”
Common priorities include staying alert for work or caregiving, avoiding a long recovery, preserving mobility, managing cost, or limiting time away from responsibilities. None of these need to be “medical” reasons to be worth stating out loud.
Step 4: Build Your Question List, in Priority Order
Visits are short, so put your most important questions first. A short, ranked list is more useful than a long one read in order of when you thought of it.
- What evidence supports this recommendation — is it strong, mixed, or limited?
- What would a positive, negative, or unclear test result change about the plan?
- Were people with backgrounds or health situations like mine included in the research behind this recommendation?
- What early warning signs should prompt me to call sooner than my next appointment?
Step 5: Decide How to Use a Support Person
If someone is joining you — a family member, friend, or caregiver — decide their role before the visit. Will they take notes, ask questions, or just listen? Are there topics you’d rather discuss privately first? Agreeing on this in advance helps keep the visit focused on your priorities rather than confusing everyone in the room.
Step 6: Set a Review Point Before You Leave
Some decisions can be revisited later; others are harder to reverse. Before the visit ends, try to get clear answers to:
- What will success look like, and by when?
- When will this decision be checked again?
- What symptoms or changes should prompt me to call sooner?
- Who do I contact, and how, if something changes?
Then write your own closing summary in plain language: “I am choosing ____ for now because ____. We will review it on ____. I should contact ____ sooner if ____.” If you leave without a full answer, write down exactly what information or conversation is still missing so the next step is clear.
Known vs. Unknown: A Quick Check Before You Go
- Known: The reasonable options for my situation, once my clinician confirms them.
- Known: My own priorities, once I’ve written them down.
- Unknown until discussed: How the evidence applies specifically to my case.
- Unknown until discussed: What the honest trade-offs are between the options for someone with my goals.
Practical Next-Step Checklist
- Write your one-sentence decision statement and your top priority.
- List every option you’re aware of, plus any questions about options you haven’t ruled out.
- Fill in a benefit/harm/burden/uncertainty line for each option.
- Rank your questions so the most important ones come first.
- Decide on the role of any support person joining you.
- Bring a way to write down the final plan and the next review date.
For help organizing your medication and symptom history before this conversation, see Organize Your Health Story. For the fuller picture of how to weigh benefits, risks, and second opinions during the conversation itself, see Take Part in Care Decisions. If you’re new to this publication, Start Here explains what it covers and what it will not do.
Common Questions
Do I need to know all my options before the appointment? No. Write down the options you’re already aware of, then ask your clinician to confirm the complete list — including whether waiting or gathering more information counts as a reasonable option in your case.
What if my clinician doesn’t ask about my priorities? You can raise them yourself. Say what outcome matters most to you before the conversation moves to a recommendation, since your care team can’t weigh a priority it doesn’t know about.
Is a second opinion always necessary? Not always. It tends to be more useful for major decisions, uncertain diagnoses, or options with serious trade-offs — and it’s worth asking whether waiting for one creates a meaningful delay in your specific situation.
Medical Information Disclaimer
This article provides general education based on publicly available guidance from the Agency for Healthcare Research and Quality. It does not diagnose, recommend a treatment, calculate personal risk, or replace advice from a licensed clinician who knows your history. If your situation is urgent or unsafe, contact your care team or local emergency services rather than waiting on this article. Page reviewed and last updated September 2026.