brevaDermatology follow-up
Encounter
Patient name: [ ] Date of birth: [ ] Date and time of encounter: [ ] Clinician: [ ]
Interval history
Condition addressed: [ ] Symptoms, distribution and change since last visit: [ ] Treatment used, adherence, response and adverse effects: [ ] Impact on daily activities and patient goals: [ ]
Examination and results
Areas examined and current findings: [ ] Comparison with documented prior findings: [ ] Tests or monitoring reviewed with dates: [ ]
Assessment and plan
Current status and clinical reasoning: [ ] Continue, change or stop treatment decisions: [ ] Medication counseling and monitoring discussed: [ ] Patient preferences: [ ]
Follow-up
Follow-up timing and purpose: [ ] Return precautions discussed: [ ] Patient questions and understanding: [ ]