| Telemedicine Consent |  | 
| Chief Complaint |  | 
| History of Present Illness |  | 
| Allergies |  | 
| Current Medications List |  | 
| Past Medical History |  | 
| Past Surgical History |  | 
| Family History |  | 
| Social History |  | 
| Physical Examination |  | 
| Physical Examination  |  | 
| LABS |  | 
| Lab Data |  | 
| ASSESSMENT & PLAN |  | 
| Assessment & Plan |  | 
| Jessica Vyas, PA-C Signature |  | 
| Time Spent |  | 

