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HPI Template: (1 of first 6 required)
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Post-Op Note
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POD
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Day/Week/Month
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Referred?
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Referring Provider
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Referring Provider Name
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PCP
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New Field
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Accompanied by
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Accompaniment Comment
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Skin cancer
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Biopsy results
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Skin Cancer Visit Type
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Prior history of skin ca?
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ENT problem
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ENT Symptoms
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Prior medication treatments
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Prior medications
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Trauma
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Cause of trauma
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Cosmetic Consultation
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Cosmetic Concern
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Accompanied by
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Accompaniment Comment
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Custom HPI: (complete sentences)
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Day/Week/Month
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Location 1
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Free text location:
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Location 2
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Location Comments (Complete sentences.)
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Pain Quality
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Quality Comments
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Severity
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Severity Comments
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Duration
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Duration Comments
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Modifying Factors***
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Modifying Factors Comments
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Onset / Timing
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Onset Comments
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Context***
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Context Comments
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Associated Symptoms***
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Associated Symptoms Comments
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Comments (full sentences)
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extra pictures
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Previous Treatment(s)
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Concern Comments
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PostOp Note
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POD
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Day/Week/Month
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