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Personal Notes

While at McLean Hospital

IntroDuction
People come to McLean Hospital in all stages
of illness. You may already have one or more
psychiatric diagnoses or an idea of what is going
on with you. Conversely, you may not have had
any prior mental health care. Writing down your
thoughts, questions and concerns about your
diagnosis and medications can be helpful, as
can reviewing these with your psychiatrist
while you are in the hospital. Nurses
are also available at all times to
answer your questions about
your diagnosis.

This booklet is a resource for your private use. You do not need to share
what you record in here with anyone unless you choose to do so.

My diagnosis is: ______________________________________________________________________________________________________________


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My medications are: ________________________________________________________________________________________________________
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Personal Notes

My Diagnosis

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Questions I have about my diagnosis: ____________________________________________________________________________________
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Symptoms or feelings I need to tell my treatment team about: _______________________________________________________
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Fears I have about my diagnosis: __________________________________________________________________________________________
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How my diagnosis may affect my future: _________________________________________________________________________________
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Personal Notes While at McLean Hospital 1

Personal Notes

Goals of My Hospitalization
Before my hospitalization, I was having difficulties with these activities: ___________________________________________
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I was worried about: ________________________________________________________________________________________________________
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I came to the hospital because: ____________________________________________________________________________________________
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I hope this hospitalization helps me to: __________________________________________________________________________________
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I am most concerned about my:

Work/School
Family
Future
Friends
Health
Body
I am also concerned about: _________________________________________________________________________________________________
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Personal Notes While at McLean Hospital

It can be especially difficult to call family and friends after being in the hospital. To help you guide the
conversation, jot down your thoughts before making the call.
Before the conversation:
Today, I want to contact: ____________________________________________________________________________________________________
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Personal Notes

Family and Friends Contact Sheet

I want to talk to him/her about: ___________________________________________________________________________________________


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I am afraid of talking to this person about: _______________________________________________________________________________
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Im going to say: ______________________________________________________________________________________________________________
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After the conversation:
We talked about: _____________________________________________________________________________________________________________
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Now I feel: ____________________________________________________________________________________________________________________
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Personal Notes While at McLean Hospital 3

Personal Notes

Family and Friends Contact Sheet


It can be especially difficult to call family and friends after being in the hospital. To help you guide the
conversation, jot down your thoughts before making the call.
Before the conversation:
Today I want to contact: ____________________________________________________________________________________________________
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I want to talk to him/her about: ___________________________________________________________________________________________
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I am afraid of talking to this person about: _______________________________________________________________________________
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Im going to say: ______________________________________________________________________________________________________________
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After the conversation:
We talked about: _____________________________________________________________________________________________________________
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Now I feel: ____________________________________________________________________________________________________________________
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Personal Notes While at McLean Hospital

Date: ___________________________________________________________________________________________________________________________
My goal for the day: _________________________________________________________________________________________________________
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The names of my nurses today: ___________________________________________________________________________________________
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Personal Notes

Daily Reflections

Activities today: _____________________________________________________________________________________________________________


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My visitors today: ___________________________________________________________________________________________________________
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I talked to my doctors about: _______________________________________________________________________________________________
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I still have these question and concerns: _________________________________________________________________________________
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I also feel: _____________________________________________________________________________________________________________________
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Personal Notes While at McLean Hospital 5

Personal Notes

Daily Reflections
Date: ___________________________________________________________________________________________________________________________
My goal for the day: _________________________________________________________________________________________________________
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The names of my nurses today: ___________________________________________________________________________________________
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Activities today: _____________________________________________________________________________________________________________
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My visitors today: ___________________________________________________________________________________________________________
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I talked to my doctors about: _______________________________________________________________________________________________
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I still have these question and concerns: _________________________________________________________________________________
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I also feel: _____________________________________________________________________________________________________________________
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Personal Notes While at McLean Hospital

Date: ___________________________________________________________________________________________________________________________
My goal for the day: _________________________________________________________________________________________________________
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The names of my nurses today: ___________________________________________________________________________________________
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Personal Notes

Daily Reflections

Activities today: _____________________________________________________________________________________________________________


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My visitors today: ___________________________________________________________________________________________________________
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I talked to my doctors about: _______________________________________________________________________________________________
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I still have these question and concerns: _________________________________________________________________________________
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I also feel: _____________________________________________________________________________________________________________________
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Personal Notes While at McLean Hospital 7

Personal Notes

Building My Resilience/Maintaining My Wellness


I derive Hope from: __________________________________________________________________________________________________________
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My Strengths and Skills are: ________________________________________________________________________________________________
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I find Healing in/from: _____________________________________________________________________________________________________
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My plan for maintaining Wellness: ________________________________________________________________________________________
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Personal Notes While at McLean Hospital

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Personal Notes

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Personal Notes While at McLean Hospital 9

115 Mill Street :: Belmont, MA :: 02478 :: www.mcleanhospital.org :: 800.333.0338


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