FOOT AND ANKLE INJURY VISIT PLANNER
Yenra | Updated October 2, 2026
Article: https://yenra.com/feet/

Record facts and the instructions your care team gives you. Do not use this sheet to
diagnose an injury or decide that urgent symptoms can wait.

Date completed: ____________________

Date and mechanism of injury:
________________________________________________________________________

Painful areas and changes since the injury:
________________________________________________________________________

Ability to bear weight at the time and now:
________________________________________________________________________

Previous injury / relevant health conditions / medicines:
________________________________________________________________________

Assessment or diagnosis explained to me:
________________________________________________________________________

Allowed weight-bearing and required support:
________________________________________________________________________

Boot or cast instructions:
________________________________________________________________________

Movement or exercises prescribed and when to begin:
________________________________________________________________________

Work / stairs / transport adjustments:
________________________________________________________________________

Warning signs and urgent contact instructions from my team:
________________________________________________________________________

Follow-up date, service, and contact:
________________________________________________________________________

Questions still unanswered:
________________________________________________________________________

SOURCE CONTEXT
The linked article explains the evidence, limits, and use of this checklist.
Authoritative references used in the article:
https://www.nhs.uk/conditions/broken-ankle/
https://www.orthoinfo.org/diseases--conditions/sprained-ankle/
https://www.orthoinfo.org/diseases--conditions/ankle-fractures-broken-ankle/

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