heart failure subjective

Symptoms: . Symptoms have been occurring for  . Associated episodes of chest pain: . Usual dry weight:
Signs or symptoms of dehydration/hypovolemia:  . Any recent or current acute illness (cold, flu, COVID, stomach flu):  . Recent weight gain: . 
Diuretic use:  . Average fluid intake per day:  . 

Risk factors: . 

Current exercise:
Pmhx: 
Surgical hx:
Current medications:
Allergies/ medication intolerances:
Current tobacco product use: 
Alcohol use:
Cannabis use:
Illicit drug use:
Anabolic steroid use: 
Influenza and pneumococcal immunizations up to date: .