Cardiovascular Soup Note.

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Primary Care Progress Notes

Last Name: ____________First Name: ____________Patient #_________Date: _____________

DOB: _____________ Sex: ____________ Phone: ________________

ACCIDENT RELATED: YES __ NO__ WORKERS COMPENSATION __ OTHER ALLERGIES: ___

VITAL SIGNS: Time Temp____ B/P _______P____ R___ Weight_____Height: ____TAKEN BY: __

CHIEF COMPLAINT:__________________________________________________________________ ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

SUBJECTIVE:_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________________________________________________________________

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OBJECTIVE:_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ _____________________________________________________________________________________

ASSESSMENT: _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

PLAN/TEST:____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

REFERRAL(S):____________________________________________________________________________________________________________________________________________________________MEDICATIONS: ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Side Effects Explained ___ Continue Same Medications___Patient Education__ Verbal__Written__ Health Education Yes__ No __

Nutrition: Regular Diet ___Diabetic Diet ___Calories ( ) __Low Fat __Low Salt ___ Ulcer Diet ___

Next Appointment: _______________Days: __________Weeks: ________Month: _______PRN:______

Provider: ___________________________________Provider Signature: __________________________

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