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Patient Info
HISTORY OF
PRESENT ILLNESS
Symptom Details
1.) Add detailed symptom -->
*Tap Here 1
- Symptom:
*Tap Here (Symptom)
- Pattern:
Tap Here (Pattern)
Other pattern:
- Onset:
Tap Here (Onset)
Other onset:
- Relieved by:
Tap Here (Relieved by)
• • •
Other "relieved by":
- Aggravated by:
Tap Here (Aggravated by)
• • •
Other "aggravated by":
- Status:
Tap Here (Status)
Other status:
- Course:
Tap Here (Course)
Other course:
- Comment:
Tap Here (Comment)
2.) Add detailed symptom -->
Tap Here 2
- Symptom:
*Tap Here (Symptom)
- Pattern:
Tap Here (Pattern)
Other pattern:
- Onset:
Tap Here (Onset)
Other onset:
- Relieved by:
Tap Here (Relieved by)
• • •
Other "relieved by":
- Aggravated by:
Tap Here (Aggravated by)
• • •
Other "aggravated by":
- Status:
Tap Here (Status)
Other status:
- Course:
Tap Here (Course)
Other course:
- Comment:
Tap Here (Comment)
3.) Add detailed symptom -->
Tap Here 3
- Symptom:
*Tap Here (Symptom)
- Pattern:
Tap Here (Pattern)
Other pattern:
- Onset:
Tap Here (Onset)
Other onset:
- Relieved by:
Tap Here (Relieved by)
• • •
Other "relieved by":
- Aggravated by:
Tap Here (Aggravated by)
• • •
Other "aggravated by":
- Status:
Tap Here (Status)
Other status:
- Course:
Tap Here (Course)
Other course:
- Comment:
Tap Here (Comment)
4.) Add detailed symptom -->
Tap Here 4
- Symptom:
*Tap Here (Symptom)
- Pattern:
Tap Here (Pattern)
- Onset:
Tap Here (Onset)
- Relieved by:
Tap Here (Relieved by)
• • •
- Aggravated by:
Tap Here (Aggravated by)
• • •
- Status:
Tap Here (Status)
- Course:
Tap Here (Course)
- Comment:
Tap Here (Comment)
5.) Add detailed symptom -->
Tap Here 5
- Symptom:
*Tap Here (Symptom)
- Pattern:
Tap Here (Pattern)
- Onset:
Tap Here (Onset)
- Relieved by:
Tap Here (Relieved by)
• • •
- Aggravated by:
Tap Here (Aggravated by)
• • •
- Status:
Tap Here (Status)
- Course:
Tap Here (Course)
- Comment:
Tap Here (Comment)
Type all other symptoms:
Tap Here (Comment)

H&P CC / History of Present Illness Medical Form

General Practice

HB Form

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Published: June 6, 2023, 11:19 a.m.
Doctor: Dr. History Physical
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Sunnyvale, CA 94089

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