After active treatment for cancer ends, it is helpful to keep a record of the cancer treatments you received and the follow-up care plan recommended by your doctor. The American Society of Clinical Oncology developed two forms that can help you keep track of this important information so it can be easily shared with health care providers who care for you throughout your lifetime.
The ASCO Cancer Treatment Plan organizes basic information about your cancer care history. This includes treatments you received, medication doses, surgeries, and any additional treatment that was given.
The ASCO Survivorship Care Plan organizes information about your recommended follow-up care plan. This includes how often you should have check-ups, the types of tests you will need, and the potential long-term late effects of the cancer treatments you received. It also provides suggestions for healthy living.
These forms are not intended to provide a complete medical record. No single treatment or survivorship care plan is appropriate for all patients due to the complexity of cancer care. Talk with your doctor for more information about your individual treatment and follow-up care. Use the ASCO Cancer Treatment Plan and Survivorship Care Plan with the guidance of your doctor.
Links below are to downloadable Microsoft Word (.docx) files unless otherwise noted.
Permission to Use ASCO Treatment and Survivorship Care Plan Templates
Patients and other consumers may use ASCO’s Treatment and Survivorship Care Plan Templates without seeking permission from ASCO.
Practitioners may incorporate the Templates into their workflow and/or into their electronic medical records system without seeking permission from ASCO. If the templates will be altered in any way, including the addition of institutional branding, ASCO requires that all ASCO identifiers be removed.
For permission to use the Templates in a commercial manner or in any manner not described above, please contact firstname.lastname@example.org.