v4

[comment memo="Version: 4
Revision Date: 1/1/22
99212 requires 1 HPI
99213 requires 1 HPI + pertinent ROS
99214 requires 4 HPI + pertinent ROS plus one other + 1 P/F/S hx
99215 requires 4 HPI + complete ROS + 2 P/F/S hx"]

Date and Time of Service:[date default="today"] [text size="8"]

Patient presents with a chief complaint of "[textarea memo="quotes" rows="1"]". Patient is a [checkbox value="male|female|other"]. Patient endorses symptoms of [checkbox value="depression|anxiety|ADHD|bipolar I|bipolar II|cyclothymic disorder|unspecified mood disorder|social anxiety|PTSD|panic disorder|eating disorder"][textarea memo="other" default="" rows="1"]. Patient reports onset of symptoms [textarea memo="onset" default="" rows="1"]. Patient reports the following precipitating events and/or stressors: [textarea memo="cause" default="" rows="1"]. The patient has noticed the following exacerbating factors: [comment memo="Exacerbating factors"][checkbox value=" isolation|reminders of past|lack of control|conflict with others"][textarea memo="other" default="" rows="1"]. However, the patient also notices that it is improved by:[comment memo="Modifying factors"] [checkbox value=" talking to someone|being alone|doing something physical like walking|doing something that is distracting"][textarea memo="other" default="" rows="1"]. Associated symptoms include: [comment memo="Associated symptoms "][checkbox value="decreased pleasure/interest|extreme guilt|low self-esteem/low-self worth|high energy|low energy|normal energy|increased appetite|decreased appetite|normal appetite|HI|SI with plan and intent|SI with plan without intent|SI without plan and without intent|thoughts of self-harm|self-harm behaviors|restlessness|muscle tightness/tension|racing thoughts|chest tightness/pain|tachycardia|shortness of breath|paresthesias|GI distress related to anxiety|sweating|lightheadedness/dizziness|shaking|agoraphobia|distractibility|grandiosity|flight of ideas|increased goal-directed activity|decreased need for sleep|talkativeness|risky behaviors|impulsive behaviors|elevated mood|binging|purging|restricting|significant weight loss or gain|difficulty with focus, concentration, inattention|difficulty completing challenging tasks|forgetfulness|fidgeting|difficulty with academic performance|flashbacks|nightmares|avoidance|feeling on edge|dissociation|auditory hallucinations|visual hallucinations|history of harming animals|history of fire setting"][textarea memo="other" default="" rows="1"]. Patient reports their depression is [select name="depression" value="none|low|medium|high"]; reports their anxiety is [select name="anxiety" value="none|low|medium|high"]; and reports they are sleeping on average [select name="sleep" value="0|1|2|3|4|5|6|7|8|9|10"] hours per night. Patient [comment memo="sleeping"][checkbox value="reports difficulty falling asleep|reports difficulty staying asleep|denies issues with sleep"]. Patient [comment memo="appetite"][checkbox value="reports increased appetite|reports decreased appetite|reports weight gain|reports weight loss|denies appetite concerns|denies weight changes"]. Patient [comment memo="side effects"][checkbox value="denies medication side effects|endorses medication side effects|is not currently taking psychiatric medications"][textarea memo="other" default="" rows="1"]. Patient [comment memo=""][checkbox value="denies SI/HI|denies psychotic symptoms including A/V hallucinations"][textarea memo="other" default="" rows="1"].