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Chief Complaint
Chief Complaint (By patient, then, docs notes)
Clinical Drawing
History of Present Illness
* Location
• • •
Quality
* Severity (__/10)
Context
* Duration (Present for the past___)
Modifying Factors
* Timing
• • •
Prior Treatments

Chief Complaint and History of Present Illness Medical Form

Podiatrist

From the 1997 Evaluation and Managment Guidelines, a template for capturing the Comprehensive structured data associated with the Chief Complaint and History of Present Illness.

There are 50 copies in use.
Published: Feb. 28, 2015, 6:47 p.m.
Doctor: Dr. History Physical
Rating: +25   /

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