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               Current Visit 
  
  
  
  
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               Initial Visit 
  
  
  
  
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               Previous Treatment 
  
  
  
  
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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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               Location Comments 
  
  
  
  
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