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HPI
|
Social HX
|
|
Family HX
|
Supplements
|
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Past Medical HX
|
|
|
|
|
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General [-]
|
General [+]
• • •
|
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General Comments
|
|
|
Energy Complaints [-]
|
Decreased Energy [+]
• • •
|
|
Energy Comments
|
|
|
SLEEP Complaints [-]
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Sleep [+]
• • •
|
|
SLEEP Comments
|
|
|
DIET Compliance [-]
|
Diet Issues[+]
• • •
|
|
Diet Comments
|
|
|
Exercise Compliance[-]
|
Exercise Issues [+]
• • •
|
|
Exercise Comments
|
|
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Cardiovascular [-]
|
Cardiovascular [+]
• • •
|
|
CV Comments
|
|
|
Respiratory [-]
|
Respiratory [+]
• • •
|
|
Resp Comments
|
|
|
GI [-]
|
GI [+]
• • •
|
|
GI Comments
|
|
|
Urinary [-]
|
Urinary [+]
• • •
|
|
Urinary Comments
|
|
|
Libido / Sexual Function (Male) [-]
|
Libido / Sexual Function (Male) [+]
• • •
|
|
Libido / Sexual Function (Male) Comments
|
|
|
Genital (Female) [-]
|
Genital (Female) [+]
• • •
|
|
Genital (Female) Comments
|
|
|
Periph. Vasc. [-]
|
Periph. Vasc. [+]
• • •
|
|
Periph. Vasc. Comments
|
|
|
MSK [-]
|
MSK [+]
• • •
|
|
MSK Comments
|
|
|
Neurologic [-]
|
Neurologic [+]
• • •
|
|
Neuro Comments
|
|
|
Endocrine [-]
|
Endocrine [+]
• • •
|
|
Endo Comments
|
|
|
Psychiatric [-]
|
Psychiatric [+]
• • •
|
|
Psychiatric Comments
|
|
