|
Persons Present in Session
|
|
|
Telemedicine Consent
|
|
|
Patient Representative Present?
• • •
|
Pt Rep: Medical Decision Maker?
|
|
Chief Complaint
|
Chief Complaint
|
|
History of Present Illness
|
HPI
|
|
Stressors
|
Stressor Categories
• • •
|
|
Review of Systems
|
|
|
Constitutional ROS
• • •
|
Other Constitutional ROS
|
|
No Constitutional Issues
|
|
|
Eyes ROS
• • •
|
Other Eyes ROS
|
|
No Eye Issues
|
|
|
Ears, Nose, Mouth, and Throat ROS
• • •
|
Other Ears, Nose, Mouth, and Throat ROS
|
|
No Ears, Nose, Mouth, and Throat Issues
|
|
|
Cardiovascular ROS
• • •
|
Other Cardiovascular ROS
|
|
No Cardiovascular Issues
|
|
|
Respiratory ROS
• • •
|
Other Respiratory ROS
|
|
No Respiratory Issues
|
|
|
Musculoskeletal ROS
• • •
|
Other Musculoskeletal ROS
|
|
No Musculoskeletal Issues
|
|
|
Gastrointestinal ROS
• • •
|
Other Gastrointestinal ROS
|
|
No Gastrointestinal Issues
|
|
|
Allergic/Immunologic ROS
• • •
|
Other Allergic/Immunologic ROS
|
|
No Allergic/Immunologic Issues
|
|
|
Endocrine ROS
• • •
|
Other Endocrine ROS
|
|
No Endocrine Issues
|
|
|
Hematologic/Lymphatic ROS
• • •
|
Other Hematologic/Lymphatic ROS
|
|
No Hematologic/Lymphatic Issues
|
|
|
Genitourinary (General)
• • •
|
Other Genitourinary (General)
|
|
No Genitourinary (General) Issues
|
|
|
Genitourinary (Women)
• • •
|
Other Genitourinary (Women)
|
|
No Genitourinary (Women) Issues
|
|
|
Genitourinary (Men) ROS
• • •
|
Other Genitourinary (Men) ROS
|
|
No Genitourinary (Men) Issues
|
|
|
Neurological ROS
• • •
|
Other Neurological ROS
|
|
No Neurological Issues
|
|
|
Integumentary (Skin/Breast and Hair) ROS
• • •
|
Other Integumentary (Skin/Breast and Hair) ROS
|
|
No Integumentary (Skin/Breast and Hair) Issues
|
|
|
Psychiatric ROS
• • •
|
Other Psychiatric ROS
|
|
No Psychiatric Issues
|
|
