This visit was performed via telemedicine. The patient confirmed knowledge of the limitations of the use of telemedicine were verbally confirmed by the provider. Verification of patient identity was established. Verbal consent was obtained for medical treatment in lieu of coronavirus related emergency.
The patient is being interviewed via [select name="variable_1" value="Phone consult|Video and Audio consult - Doxy.me|Other mode of Video consultation"]
Patinet complains of [textarea name="variable_1" default=""]
Patient had the symptmos x [select name="variable_2" value="1|2|3|4|5|6|7"][select name="variable_3" value="days|weeks|months"].
Associated symptoms[textarea name="variable_2" default=""] Patient denies[checkbox name="variable_10" value="chest pain|dyspnea|lower ext edema|hemoptasis |Fever|sore throat|nasal congestion|earache|headache|myalgias|pain with neck movement|Pain with opening mouth|dysphagia"]
Tx:[text name="variable_1" default=""]
Patient has [select value="no known|known"] sick contacts with similar symptoms Patient has no recent travel
History of pulmonary problems: [checkbox name="pulmhx" value="no respiratory problems|frequent pneumonia|frequent bronchitis|asthma|other"][conditional field="pulmhx" condition="(pulmhx).is('other')"][text size=72 memo="<--describe other"][/conditional]
Tobacco use hx: [checkbox name="tobacco" value="Patient is not a smoker|Patient is a current or former smoker|Patient is exposed to second hand smoke"][conditional field="tobacco" condition="(tobacco).is('Patient is a current or former smoker')"] [text size=72 memo="<--smoking details (optional)"][/conditional].
Diagnostic rationale, follow up instructions, and strict precautions/indications for emergent direct evaluation were discussed with the patient. The patient agrees with the plan, and understands to follow up with their primary care physician or other healthcare provider within 48-72 hours for reevaluation for persistent or worsening symptoms.