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               Location 
  
  
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               Location Comments 
  
  
  
  
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               Quality 
  
  
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               Quality Comments 
  
  
  
  
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               Severity 
  
  
  
  
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               Severity Comments 
  
  
  
  
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               Duration 
  
  
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               Duration Comments 
  
  
  
  
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               Onset / Timing 
  
  
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               Onset Comments 
  
  
  
  
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               Context 
  
  
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               Context Comments 
  
  
  
  
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               Modifying Factors 
  
  
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               Modifying Factors Comments 
  
  
  
  
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               Associated Symptoms 
  
  
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               Associated Symptoms Comments  
  
  
  
  
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               Previous Treatment 
  
  
  
  
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               New Short Text Field 
  
  
  
  
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               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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               Childhood illnesses 
  
  
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               Comments 
  
  
  
  
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               Childhood Immunizations 
  
  
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               Comments 
  
  
  
  
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               Date of last PE 
  
  
  
  
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               PCP 
  
  
  
  
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               PCP Contact Information 
  
  
  
  
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               Family History 
  
  
  
  
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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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               Grandparent's MH 
  
  
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               Comments 
  
  
  
  
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               Children(s)' MH 
  
  
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               Comments 
  
  
  
  
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               Social History 
  
  
  
  
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               Marital Status 
  
  
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               Living Arrangements 
  
  
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               Potential Environmental Pathogen 
  
  
  
  
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               Sexual Hx 
  
  
  
  
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               Comments 
  
  
  
  
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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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               Patient's diet 
  
  
  
  
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               General [-] 
  
  
  
  
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               General 
  
  
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               General Comments 
  
  
  
  
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               Skin [-] 
  
  
  
  
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               Skin 
  
  
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               Skin Comments 
  
  
  
  
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               HEENT [-] 
  
  
  
  
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               HEENT 
  
  
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               HEENT Comments 
  
  
  
  
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               Neck [-] 
  
  
  
  
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               Neck 
  
  
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               Neck Comments 
  
  
  
  
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               Breasts [-] 
  
  
  
  
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               Breasts 
  
  
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               Breasts Comments 
  
  
  
  
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               Cardiovascular [-] 
  
  
  
  
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               Cardiovascular 
  
  
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               CV Comments 
  
  
  
  
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               Respiratory [-] 
  
  
  
  
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               Respiratory 
  
  
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               Resp Comments 
  
  
  
  
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               GI [-] 
  
  
  
  
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               GI 
  
  
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               GI Comments 
  
  
  
  
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               Urinary [-] 
  
  
  
  
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               Urinary 
  
  
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               Urinary Comments 
  
  
  
  
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               Genital (Male) [-] 
  
  
  
  
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               Genital (Male) 
  
  
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               Genital (Male) Comments 
  
  
  
  
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               Genital (Female) [-] 
  
  
  
  
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               Genital (Female) 
  
  
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               Genital (Female) Comments 
  
  
  
  
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               Periph. Vasc. [-] 
  
  
  
  
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               Periph. Vasc. 
  
  
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               Periph. Vasc. Comments 
  
  
  
  
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               MSK [-] 
  
  
  
  
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               MSK 
  
  
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               MSK Comments 
  
  
  
  
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               Neurological [-] 
  
  
  
  
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               Neurological 
  
  
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               Neuro Comments 
  
  
  
  
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               Endocrine [-] 
  
  
  
  
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               Endocrine 
  
  
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               Endo Comments 
  
  
  
  
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               Psychiatric [-] 
  
  
  
  
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               Psychiatric 
  
  
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               Psychiatric Comments 
  
  
  
  
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               General WNL 
  
  
  
  
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               General Abnormal 
  
  
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               General Comments 
  
  
  
  
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               HEENT WNL 
  
  
  
  
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               HEENT Abnormal 
  
  
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               HEENT Comments 
  
  
  
  
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               Skin WNL 
  
  
  
  
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               Skin Lesion 
  
  
  
  
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               Skin Comments 
  
  
  
  
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               Neck WNL 
  
  
  
  
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               Neck Abnormal 
  
  
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               Neck Comments 
  
  
  
  
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               Cardiovascular WNL 
  
  
  
  
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               Cardiovascular Abnormal 
  
  
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               Cardiovascular Comments 
  
  
  
  
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               Lungs WNL 
  
  
  
  
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               Lungs Abnormal 
  
  
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               Lungs Comments 
  
  
  
  
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               Abdomen WNL 
  
  
  
  
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               Abdomen Abnormal 
  
  
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               Abdomen Comments 
  
  
  
  
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               MSK WNL 
  
  
  
  
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               MSK Abnormal 
  
  
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               MSK Comments  
  
  
  
  
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               Breasts WNL 
  
  
  
  
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               Breasts Abnormal 
  
  
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               Breasts Comments 
  
  
  
  
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               Neuro WNL 
  
  
  
  
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               Neuro Abnormal 
  
  
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               Neuro Comments 
  
  
  
  
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               Extremities WNL 
  
  
  
  
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               Extrem Abnormal 
  
  
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               Extrem Comments 
  
  
  
  
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               | 
          
          
| 
               Assessment 
  
  
  
  
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               | 
          
          
| 
               Labs 
  
  
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               Lab Comments 
  
  
  
  
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               Radiology 
  
  
  • • •
  
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               Radiology Comments 
  
  
  
  
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               PT Recommendations 
  
  
  
  
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               PT Recommendation Comments 
  
  
  
  
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               Home Health  
  
  
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               Home health comments 
  
  
  
  
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               Referrals  
  
  
  
  
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               Referral Comments 
  
  
  
  
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               Education 
  
  
  
  
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               Education Comments 
  
  
  
  
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               Diet 
  
  
  
  
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               Diet Comments 
  
  
  
  
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               General Instructions  
  
  
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               General Instruction Comments 
  
  
  
  
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