HISTORY:
Current weight:
BMI:
Attempts to lose weight so far: , , , , , ,
, /IV
Other elements:
EXAM:
General appearance:
Vital signs: , BP , HR , RR , SpO2 %, Temp °
Neck:
Heart: ,
Lungs: ,
Abdomen: , , ,
Extremities: , , cap refill , pulses ,
Musculoskeletal: joints ,
ASSESSMENT:
DDx:
PLAN:
- Blood work: , , , ,
- Increase physical activity
- Dietary counseling
-
- Behavioral therapy
- Referral to dietitian
- Referral to weight loss clinic
- Referral to endocrinologist
- Referral to bariatric surgery
- Follow-up in months