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,
including
family and friends?1,3

Please select one:

Question 6:

Do you experience any of the following because of your
involuntary
movements?1-3

Select all that apply:

Stress
Embarrassment
Isolation
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