Tool 1 · Meaningful change recordSomething changed—capture the useful part.
You do not need to record every sensation. Use this when something is new, persistent, clearly different, or important to your daily life.
What changed?
____________When did it start?
____________What pattern do I notice?
____________What happens with it?
____________How is it affecting my life?
____________What changed around the same time?
____________
Tool 2 · Quality-of-life priorityChoose one thing you want your care to help protect or improve.
What matters to me?
____________What is making it difficult?
____________What would “better” look like?
____________What help or decision do I need?
____________
Your goal can be practical: enough energy for family time, sleeping well enough to concentrate, continuing work or study, moving with less difficulty, or planning safely for pregnancy.
Tool 3 · One-page visit briefBring the essentials into the appointment.
My main health change:
____________Its impact on my life:
____________My priority:
____________The decision I need help with:
____________My three questions:
1. ___ 2. ___ 3. ___My updated medicine list:
ready / needs updating
Tool 4 · Understand my medicinesTurn a medicine list into a plan you understand.
Medicine / supplement
____________Why do I use it?
____________How was I told to use it?
____________What monitoring was I asked to complete?
____________What safety instructions was I given?
____________My question about it
____________
Do not use this template to decide doses or make treatment changes. If an instruction is unclear, confirm it with your healthcare team or pharmacist.
Tool 5 · Tests and follow-upKnow why a test matters before focusing on the number.
Test / monitoring item
____________Date
____________Why was it requested?
____________What did my clinician explain?
____________What happens next?
____________My question
____________
A single result may not explain your health by itself. Review results and trends in their clinical context rather than using this template for self-diagnosis.
Tool 6 · Review what happenedDid the plan help what matters to you?
What were we trying to improve or protect?
____________What changed since then?
____________What is better, worse or unchanged in daily life?
____________What do I want to review next?
____________
This closes the self-management loop: Notice → Prioritize → Discuss → Act on the agreed plan → Review.
Choose the right toolYou do not need to complete everything.
Something changed?
Use the meaningful change record.Life is becoming harder?
Choose a quality-of-life priority.Appointment coming?
Prepare the one-page visit brief.Confused about treatment?
Organize your medicines and questions.
Measurement boundaryThese NA7N templates are not validated clinical questionnaires.
They are organizational and communication tools. NA7N will distinguish them from validated patient-reported outcome measures and will not present an unofficial translation, restricted instrument or informal score as a validated measure of lupus activity.
SafetyDo not complete a form when you need medical assessment.
Severe or rapidly worsening symptoms require medical assessment rather than waiting to finish a tool or collect more information. Follow any individualized urgent-care instructions already provided by your healthcare team.
Editorial status
Last editorial update: October 2026.
Internal medical review: Pending documented clinician review. NA7N does not claim medical review before it occurs.