Adult Illnesses

Inquire about illnesses such as diabetes, hypertension, or asthma and hospitalizations.

Surgical

Document dates, indications, and types of surgical procedures.

Obstetric/Gynecologic

Document number of pregnancies (gravida), number of deliveries (para-term, preterm, abortions, and living children), menstrual history, methods of contraception, and sexual function.

Psychiatric

Document diagnoses, hospitalizations, treatments, and the time frame.

Health Maintenance

Document ...