Assault History
[text default="Assault"] Onset [text] prior to evaluation Onset while: [text] Episode location: [text] Episode description: [text]. Weapons involved: [text] Associated Injuries: [text] ROS [select value="no|YES"] <-- seizure [select value="no|YES"] <-- extremity weakness [select value="no|YES"] <-- headache [select value="no|YES"] <-- sensory changes (vision, hearing) [select value="no|YES"] <-- shortness or breath [select value="no|YES"] <-- chest pain [select value="no|YES"] <-- nausea/vomiting [select value="no|YES"] <-- incontinence of urine or stool [checkbox memo="display/hide references" name="footnotes" value=""][conditional field="footnotes" condition="(footnotes).is('')"] reference: contributed by Dr. Scott Moses, creator/author of the Family Practice Notebook [link url="//www.fpnotebook.com" memo="(link)"][/conditional]
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