CARLOTTA
A RUSSE V5
PC
, Carlotta zA zRusse zV5 zPC
zInterview
Chief zComplaint
How zcan z I zhelp zyou
ztoday?
Do zyou zhave zany zother zsymptoms zor zconcerns zwe zshould zdiscuss?
zHave zyou zhad z any ztrauma zto zyour zback?
Old zcarts zfor zHPI
What zare zthe zevents zsurrounding zthe zstart zof zyour zback zpain?
What zare zthe zevents zsurrounding zthe zstart zof zthe zpain zin zyour zleg(s)?
zWhen zdid zthe z pain zin z your z back z start?
Does zthe zpain zin zyour zback zradiate zsomeplace zelse? zWhere?
zWhere zmore zprecisely z is z the z pain z in zyour zleg(s)?
Where zmore zprecisely zis zthe zpain zin zyour
zback? zDoes zthe zpain zin z your z back zcome zand
zgo?
What zdoes zthe zpain zin zyour zback zfeel zlike?
zDo zyou zhave z pain zwhen zlifting?
Does zanything zmake zthe zpain zin zyour zback zbetter zor zworse?
zHow z severe z (1-10 zScale) zis zthe zpain zin z your z back?
PMH, zFH, zSH zas zNeeded
Any znew zor zrecent zchange zin zmedications?
Are zyou ztaking zany zover zthe zcounter zor zherbal zmedications?
zDo zyou zhave z any z allergies?
Review zof zSystems z(ROS)
Do zyou zhave zproblems zwith zheat zor zcold zintolerance, zincreased zthirst, zincreased zsweating,
zfrequent zurination, z or z change zin z appetite?
Do zyou zhave zproblems zwith zdizziness, zfainting, zspinning zroom, zseizures, zweakness, znumbness,
ztingling, z or ztremor?
Do zyou zhave zproblems zwith zfatigue, zdifficulty zsleeping, zunintentional zweight zloss zor zgain,
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