2 pts
3 pts
4 pts
5 pts
Chronological, includes onset of problem & describes in terms of location, quality, quantity,timing, factors that aggravate or associated manifestations
include dates
Tobacco ETOH Illicit drug use Occupation Diet/Exercise Married?Children? Religious if relevant Socioeconomic
Age and health or cause of death Genogram: three generational, age of diagnosis, age of death
Current meds Dose Frequency Route<BR> CAM
Karnofsky or Lansky
Vital signs weight Height BMI
All systems
Summary of the patient with main symptoms/diagnosis,cancer stage
For all active problems: Therapeutic interventions Counseling/education prevention /Screening strategies Referrals Follow up
Presentation should be 20 minutes