Questionnaire
Symptom tracker, three times a week
The sheet she gets three times a week
Hot flushes in the last 24 hours
None1 to 34 to 78 or more
How much did they disturb you?
012345678910
0 means not at all, 10 means they dominated the day.
How did you sleep?
Slept throughWoke onceWoke two or three timesBarely slept
Anything new you want to report?Optional
Not answered
Bleeding, breast tenderness, headache, mood. Leave it empty if there is nothing.
Nothing here changes your treatment on its own. If an answer needs a look before your next visit, Dr. Weber sees it the same day.
Sources
Plan 18.09.2026S3-Leitlinie Peri- und Postmenopause
Set up by the physician when she signed the plan: which questions, how often, for how long. The schedule stops on its own after six weeks; nothing keeps asking forever.