|
Stable HTN
|
Uncontrolled HTN
|
|
Stable CAD
|
Uncontrolled CAD
|
|
Stable CHF
|
Uncontrolled CHF
|
|
Stable Afib
|
Uncontrolled Afib
|
|
Stable DM2
|
Uncontrolled DM2
|
|
Stable HLD
|
Uncontrolled HLD
|
|
Stable COPD
|
Uncontrolled COPD
|
|
Stable Hypothyroid
|
Uncontrolled Hypothyroid
|
|
COVID Swab performed
|
COVID Ab Test plan to draw
|
|
COVID AB Positive Result
|
COVID AB Negative Result
|
|
Other Diagnosis 1
|
Plan 1
|
|
Other Diagnosis 2
|
Plan 2
|
|
Other Diagnosis 3
|
Plan 3
|
|
Advanced Directives
• • •
|
|
|
Time spent on patient care
|
|
|
NH instructions/disclaimer
|
|
|
Discussion of Assessment and Plan
• • •
|
|
|
Cosign
|
|
