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Past Medical History
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Past Medical History
• • •
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Past Medical History Freewrite
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Past Surgical History
• • •
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Comments
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PCP
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PCP Contact Information
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Social History
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Marital Status
• • •
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Comment
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Living Arrangements
• • •
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Children?
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Occupation
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Caffeine
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Comments
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Alcohol
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Comments
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Other substances
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Family Medical History
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Contributory?
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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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SOAP Objective
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Objective SOAP?
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Physical exam findings?
• • •
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Comments
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Pulse / Tongue Check Up?
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Pulse by palpation:
• • •
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Comments
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Tongue by observation
• • •
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Comments
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