My Guide

Thank you for completing the TD Doctor Discussion Guide

Take a moment to review the summary of your answers below with a family member or friend. If you would like to change a response, hit the “start over” button. When you’re ready, you can access a copy of your guide to take to your next appointment by either emailing it to yourself or downloading and printing it.

Question 1:

Where do you experience involuntary body movements such as twitching,
shaking, or jerking?1

Select all that apply:

Image depicting areas of the body used to calculate the Abnormal Involuntary Movement Scale (AIMS) total score.

Question 2:

Do you experience any of the following other
types of involuntary movements?1

Select all that apply:

Question 3:

How often do you experience these involuntary movements?1,2

Please select one:

Question 4:

Do you have trouble with any of these daily activities?1-3

Select all that apply:

Speaking or being understood by others.
Reading or writing.
Cutting your food or holding a drink.
Walking (problems with balance or coordination)

Question 5:

Do your movements make you feel self-conscious around others,
family and friends?1,3

Please select one:

Question 6:

Do you experience any of the following because of your

Select all that apply:

Pain and Discomfort.
Sleep Loss

Remember to take your completed
guide with you

Don’t forget to print or email your guide and take it to your next appointment to
start a conversation about your TD symptoms and treatment with your doctor.

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References: 1. Warikoo N, Schwartz TL, Citrome L. Tardive dyskinesia. In: Schwartz TL, Megna J, Topel ME, eds. Antipsychotic Drugs: Pharmacology, Side Effects and Abuse Prevention. Nova Science Publishers, Inc; 2013:235-258. 2. Waln O, Jankovic J. An update on tardive dyskinesia: from phenomenology to treatment. Tremor Other Hyperkinet Mov (N Y). 2013;3:tre-03-161-4138-1. Published online July 12, 2013. doi:10.7916/D88P5Z71