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Chief Complaint:which side of heel?
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Duration
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experienced a similar condition in the past?
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Patient rates pain as
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Patient admits to
• • •
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Past Medical History
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Past Medical History
• • •
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Comments
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Past Surgical History
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Past Surgical History
• • •
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Comments
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Family History:
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Father's MH
• • •
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Comments
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Mother's MH
• • •
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Comments
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Sibling(s)' MH
• • •
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Comments
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Grandparent's MH
• • •
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Comments
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Children(s)' MH
• • •
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Comments
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Social History:
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Patient smokes?
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if yes, how much?
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Alcohol
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Comments
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Caffeine
• • •
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Comments
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Other substances
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Patient's diet
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ROS:
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Constitutional symptoms:
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Eyes:
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Ears, Nose, Mouth, Throat:
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Cardiovascular [-]
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Cardiovascular
• • •
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Comments
|
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Respiratory [-]
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Respiratory
• • •
|
|
Comments
|
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GI [-]
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GI
• • •
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Comments
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|
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GU:
|
|
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MSK [-]
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MSK
• • •
|
|
Comments
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|
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Integumentary:
|
|
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Neurological [-]
|
Neurological
• • •
|
|
Comments
|
|
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Psychiatric [-]
|
Psychiatric
• • •
|
|
Comments
|
|
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Endocrine [-]
|
Endocrine
• • •
|
|
Comments
|
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Hematologic/Lymphatic:
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Allergic/Immunologic:
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Examination:
• • •
|
Comments
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Dermatological: (use Macro)
|
|
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Vascular: Dorsalis
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Digital capillary
|
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Evidence of ischemic skin changes?
|
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Neurological: (use Macro)
|
Percussion of the tarsal tunnel?
|
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which side?
|
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Musculoskeletal: (use Macro)
|
Radiographs: (use macro)
|
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Assessment:
|
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Plantar Fasciitis
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Treatment: (use macro)
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