|
C/C & HPI
|
|
|
C/C - Body
• • •
|
C/C - Psychology:
• • •
|
|
C/C - Intimacy
• • •
|
C/C - Skin.Hair
• • •
|
|
C/C - Musculoskeletal
• • •
|
C/C and HPI
|
|
Other:
|
|
|
History of Present Illness
|
|
|
History of Present Illness
|
HPI - Severity
|
|
HPI - Details
|
Other:
|
|
Subjective - Daily Activity
|
|
|
Subjective - Sleep
|
Subjective - Water
|
|
Subjective - Time of Exercise
|
Subjective- Hours of Exercise
|
|
Other:
|
|
|
Subjective- Metabolic Activity
|
|
|
Subjective- Energy Levels
• • •
|
Subjective- Concentration Levels
• • •
|
|
Subjective- Libido Levels
• • •
|
Subjective- Stress Levels
• • •
|
|
Other:
|
|
|
DISCLOSURES
|
|
|
Patient Treatment and Partnership Discussion
|
Hormone Therapy Disclosure
|
|
Laboratory Essentials
|
|
|
PHYSICAL EXAM
|
|
|
Physical Exam Performed
|
TELEMEDICINE VISIT
|
|
Other:
|
|
|
Assesment
|
|
|
Assessment - Body:
|
Assessment - Psychological/Emotional:
|
|
|
|
|
|
C/C and HPI
|
|
Other:
|
Other:
|
|
PLAN
|
|
|
Wellness Plan
• • •
|
Plan Details
|
|
Follow up
|
|
|
Personalized Treatment Protocol
|
|
|
Insulin Sensitizers/Stabilizers
|
Cholesterol Lowering Supplements
|
|
B-12/B-Complex Supplementation
|
Thyroid Support/Supplementation
|
|
Testosterone Supplementation
|
Vitamin D-3 Supplementation
|
|
DHEA Supplementation
|
Pregnenolone Supplementation
|
|
Estradiol Supplementation
|
Progesterone Supplementation
|
|
Growth Hormone/Peptide Supplementation
|
Melatonin Supplementation
|
|
Intermittent Fasting
|
Anit-Inflammatory Diet
|
|
Training/Workout
|
HCG Weight Loss Program
|
|
GLP-1 Weight Loss Program
|
Peptide Therapy
|
|
Longevity Program
|
Intermittent Fasting
|
