Adolescent + Young Adult (AYA) Cancer Program

Welcome to, Be Prepared: Your Online Toolkit, created with you in mind. Whether you have an extensive medical history or are going to the doctor for the first time since you were a kid, the forms included here will save you time, money and energy.

Click on the document titles to download the forms and then choose to save or print. Clicking on the module header will download all forms in that section. Fill out the forms and store them in a designated place so you have them readily accessible when you need them. Don’t forget to bring them to your next appointment!

Before Your Visit:

How to prepare for your visit

• Appointment Checklist
• What You Want To Cover: Concerns, Goals and Questions
  • Sample
• Symptom Journal
  • Sample

Collecting Information

• Medications Log
• Family History Log
• Vaccination Log
• Hospitalizations or Surgeries Log

General Health

• Health Problems Checklist
• Health Behaviors Checklist
• Females Only: Menstrual Period Checklist

After Your Visit:

How to Keep Track

• Suggested Record Keeping Apps
• Doctor Contact List
• Appointment Summary Log

Health Insurance

• Health Insurance Interaction Log

Download all Forms

This toolkit has been reviewed by Dr. Susan Parsons of the Reid R. Sacco Adolescent & Young Cancer Program at Tufts Medical Center. Materials were adapted from the City of Hope National Medical Center, Duarte, CA, The Patient’s Toolkit for Diagnosis developed by Society to Improve Diagnosis in Medicine (SIDM) Patient Engagement Committee and Cancer + Careers online resources.

Stupid Cancer
Find resources dedicated to AYAs, listen to the Stupid Cancer Show podcast, sign up for an in-person AYA conference or learn about the Instapeer app which enables you to connect with others with a similar cancer history.

Imerman Angels 
Imerman Angels matches you with someone who has a similar cancer history, providing one-on-one-cancer support.  Sign up as a mentor or request one.

I Had Cancer 
Signing up as a member for this site gives you access to read other young adult survivor, fighter and supporter stories as well as participate in real discussions. 

Critical Mass 
Also known as the Young Adult Cancer Alliance, Critical Mass is a community-powered advocacy organization which offers the latest in AYA related news, an e-newsletter and Mission Control (a one stop shop for resources).

Next Step 
Located in Cambridge, MA this organization works with adolescents and young adults who have/are facing life-threatening illnesses including cancer. They include a focus on childhood cancer survivors.

Cancer and Careers
This site provides a comprehensive set of tools to assist individuals with a history of cancer at any stage of the work continuum, from those searching for a job to those already employed.

Resume Genius
Create your resume with Resume Genius’ free Resume Builder.

Need help finding a new job?  Check out:

• Linked In
• Idealist
• Simply Hired
• Indeed

Circle Surrogacy
Learn more about surrogacy on this site.

LIVESTRONG
Get the tools and resources you need to help you become a parent after cancer.

The Oncofertility Consortium
This site answers fertility FAQ and explores reproductive options for individuals with a history of cancer.

The SAMFund
Financial grants are given to young adult cancer survivors to help them get back on their financial feet. 

Looking for help going back to school?  Check out:

• The Cancer Survivors Fund
• The Patient Advocate Foundation Scholarship for Survivors
• Ulman Fund

First Descents
Join other AYAs (18-39) on a multi-day adventure centered around whitewater kayaking, rock climbing or surfing. 

True North Treks
Designed for AYA cancer survivors, treks include backpacking in Idaho or canoeing in Montana or Utah.

Ulman Cancer fund for Young Adults
Join a Cancer to 5K team (Boston’s team starts March 28, 2016).  This free, 12-week training program is designed to introduce or reintroduce cancer survivors to physical activity. 

Project Koru
Offerings include snowboarding and surfing adventures as well as weekend workshop retreats. For AYAs diagnosed between ages 18-39.

YMCA LIVESTRONG Program
This 12-week group exercise program was created for cancer survivors and is available at various YMCA locations, including Boston’s Wang YMCA which is a short walk from Tufts Medical Center.  

National Cancer Legal Services Network
Receive free legal assistance and referrals for issues ranging from insurance disputes to employment.

Patient Advocate Foundation
Get help solving insurance and healthcare access issues.

Triage Cancer
Provides information and resource pages regarding legal, insurance and employment resources in each state.

Academy of Nutrition and Dietetics
Read articles and watch videos on ways to eat healthier.  The site includes a food, health and fitness section.

Fooducate
Use Fooducate App to scan and find healthy foods as well as to track your healthy eating progress.

United States Department of Agriculture
This site provides advice on what to eat, recipes and offers daily food plans.