brevaSkin lesion assessment
Encounter
Patient name: [ ] Date of birth: [ ] Date and time of encounter: [ ] Clinician: [ ]
Lesion history
Site and laterality: [ ] Duration, change and associated symptoms: [ ] Prior treatment and relevant risk history: [ ]
Findings
Location, dimensions and morphology: [ ] Examination and dermoscopy findings if performed: [ ] Photograph or body-map reference if obtained: [ ]
Assessment
Clinical impression and differential: [ ] Reasoning for observation, treatment or tissue sampling: [ ]
Plan and procedures
Options and consent discussion: [ ] Procedure details if performed, including site verification and anesthetic used: [ ] Specimen label, destination and requested test if collected: [ ] Aftercare and result communication plan: [ ] Clinician responsible for reviewing results: [ ]
Follow-up
Follow-up timing and purpose: [ ] Return precautions discussed: [ ] Patient questions and understanding: [ ]