SU_NSG6435_W1_A3_Nelson_M

PEDIATRIC FILLABLE SOAP NOTE TEMPLATE 1 | P EDIATRIC SOAP NOTE STUDENT NAME: DATE OF ASSIGNMENT: Patient Initials: Date of Encounter: Sex: Age/DOB/Place of Birth: SUBJECTIVE Historian: Present Concerns/CC: Reason given by the patient forseeking medical care “in quotes” Child Profile: (Sexual History (If appropriate); ADLs (age appropriate); Safety Practices; Changes in daycare/school/after-school care; Sports/physical activity; Developmental Hx) HPI: (must include all components - OLD CARTS) Medications: (List with reason for meds) PMH: Allergies: Medication Intolerances: Chronic Illnesses/Major traumas: Hospitalizations/Surgeries: Immunizations: PEDIATRIC FILLABLE SOAP NOTE TEMPLATE 2 | P EDIATRIC SOAP NOTE Family History (please identify all immediate family) Social History (Education level, occupational history, current living situation/partner/marital status, substance use/abuse, ETOH, tobacco, and marijuana. Safety status) Review of Systems (ROS) General Cardiovascular Skin R