Step 1
33.3

Diagnosed with EoE? Sharing your experience with your doctor and asking questions can help.

It can be hard to discuss EoE. Speaking openly and honestly with your doctor can support your treatment journey. This guide can help you organize your thoughts and understand your experience managing EoE to better start a conversation with your doctor. If you are a caregiver, please fill this out on behalf of your loved one living with EoE.

This is a sample dialogue to get the conversation started. It is not, nor is it intended to be, a medical evaluation, examination, advice, consultation, diagnosis, or treatment. Always consult your healthcare professional.

The information shared here will be used in accordance with Takeda’s Privacy Policy, which can be viewed here.

1
Do you experience any of these symptoms when eating? (check all that apply)
2
How long have you been experiencing these symptoms?
3
How often do you have these symptoms?
Step 2
66.6

How has managing your EoE been going?

This is a sample dialogue to get the conversation started. It is not, nor is it intended to be, a medical evaluation, examination, advice, consultation, diagnosis, or treatment. Always consult your healthcare professional.

 

4
Which of the following behaviors have you used to help manage your EoE? (check all that apply)
5
Do you take any medications to help manage your EoE symptoms? (check all that apply)
6
If you are on a treatment for EoE, how satisfied are you with it?
Step 3
99.9

Finally, let’s figure out how EoE affects your day to day.

This is a sample dialogue to get the conversation started. It is not, nor is it intended to be, a medical evaluation, examination, advice, consultation, diagnosis, or treatment. Always consult your healthcare professional.

 

7
8
How often do you avoid eating in social settings?
9
10
How often do you avoid certain foods because of symptom concerns?

You’re all set!

Choose an option to receive your Doctor Discussion Guide, so you can bring it with you to your next appointment!

After you talk to your doctor, you may want to consider:

Where would you like us to send your Doctor Discussion Guide?

*Required field.

The personal information you provide as part of this tool will be used solely to allow you to generate a discussion guide to share with your healthcare provider. The information shared here will be used in accordance with Takeda’s Privacy Policy, which can be viewed here.

Please review Takeda's Privacy Notice at www.takeda.com/privacy-notice.

Thank you for adding your email address. Please check your inbox for your Doctor Discussion Guide.