|
General [-]
|
General
• • •
|
|
General [+]
|
General
• • •
|
|
General Comments
|
|
|
Skin [-]
|
|
|
Skin
• • •
|
Skin Comments
|
|
HEENT [-]
|
HEENT
• • •
|
|
HEENT Comments
|
|
|
Neck [-]
|
Neck
• • •
|
|
Neck Comments
|
|
|
Breasts [-]
|
Breasts
• • •
|
|
Breasts Comments
|
|
|
Cardiovascular [-]
|
Cardiovascular
• • •
|
|
CV Comments
|
|
|
Respiratory [-]
|
Respiratory
• • •
|
|
Resp Comments
|
|
|
GI [-]
|
GI
• • •
|
|
GI Comments
|
|
|
Urinary [-]
|
Urinary
• • •
|
|
Urinary Comments
|
|
|
Genital (Male) [-]
|
Genital (Male)
• • •
|
|
Genital (Male) Comments
|
|
|
Genital (Female) [-]
|
Genital (Female)
• • •
|
|
|
|
|
Periph. Vasc. [-]
|
Periph. Vasc.
• • •
|
|
Periph. Vasc. Comments
|
|
|
MSK [-]
|
MSK
• • •
|
|
MSK Comments
|
|
|
Neurological [-]
|
Neurological
• • •
|
|
Neuro Comments
|
|
|
Endocrine [-]
|
Endocrine
• • •
|
|
Endo Comments
|
|
|
Psychiatric [-]
|
Psychiatric
• • •
|
|
Psychiatric Comments
|
|
|
Pain
|
Pain
• • •
|
|
Location of Pain:
• • •
|
Other Location:
|
|
Provoking Factors:
• • •
|
Comments
|
|
Quality:
• • •
|
Comments
|
|
Region/Radiation:
• • •
|
Comments
|
|
Severity
• • •
|
Comments
|
|
Timing:
• • •
|
Comments
|
|
Relieving Factors:
• • •
|
Comments
|
