brevaAnxiety follow-up
Encounter
Patient name: [ ] Date of birth: [ ] Date and time of encounter: [ ] Clinician: [ ]
Interval history
Changes since the previous visit: [ ] Symptoms, triggers and functional impact as reported: [ ] Sleep and substance use as reported: [ ] Coping strategies used: [ ]
Measures
Screening tool used, score and date: [ ] Previous score and date for comparison: [ ] Depression screening result if performed: [ ]
Treatment
Medication use as reported, response and adverse effects: [ ] Therapy or counseling engagement: [ ]
Assessment and plan
Current status and reasoning: [ ] Medication decisions and rationale: [ ] Therapy referral or coordination: [ ] Safety concerns assessed and actions taken: [ ]
Follow-up
Follow-up timing and purpose: [ ] Return precautions discussed: [ ] Patient questions and understanding: [ ]