Complete a problem – focused SOAP note. Please follow the template attached. Case will be provided
Demographic Data
Age, and gender (must be HIPAA compliant)
Subjective
History of Present Illness (HPI) in paragraph form (remember OLDCART: Onset, Location, Duration, Characteristics, Aggravating/Alleviating Factors, Relieving Factors, Treatment)
Past Med. Hx (PMH): Medical or surgical problems, hospitalizations, medications, allergies, immunizations, and preventative health maintenance as applicable
Objective
Include all diagnoses that apply for this visit
Plan
Tx Plan: (meds)
Referral/Follow-up
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Turnitin Report
Formatting
Title Page
Citation
Outline
