Enhancements to patient forms for a better pre-appointment experience Copied
We made updates to several patient forms to make completion easier for patients and to help your practice gather comprehensive information for effective treatment. These enhancements also aim to improve the efficiency and accuracy of patient information collection.
Review of Systems Form
- Name Change: The form has been renamed to Review of Systems (callout 1).
- Step 1: Updated instructions for height and weight questions to now read as: “Please enter your most recent height and weight” (callout 2).

- Step 2: Updated the symptom options for several health issues, including:
- Respiratory (callout 3):
- Chronic Cough
- Coughing Up Blood
- Difficulty Breathing
- Dry Cough
- Productive Cough
- Short of Breath
- Spit Up Blood
- Uses Oxygen (additional information requested)
- Wheezing/Asthma
- None
- Gastrointestinal (callout 4):
- Blood in Stool
- Change in Weight
- Chronic Stomach Pain
- Clay-Colored Stools
- Constipation
- Diarrhea
- Heartburn
- Hemorrhoids
- Loss of Appetite
- Nausea/Vomiting
- Ulcers
- Vomit Blood
- None
- Eyes (callout 4):
- Blurred Vision
- Dizzy Spells
- Double Vision
- Eye Pain
- Failing Vision
- Glasses or Contacts
- Glaucoma
- History of Glaucoma
- See “Floating Lights”
- Severe Headaches
- Vision Changes
- None

- Respiratory (callout 3):
- Step 3: Updated the symptom options for several health issues, including:
- Head & Neck (callout 6):
- Chronic Nose Obstruction
- Discharge From Ear(s)
- Dry Mouth
- Ear Pain
- Hearing Aid (Left Ear)
- Hearing Aid (Right Ear)
- Hearing Loss
- Hoarseness
- Mouth Sores
- Dental Problems
- Difficulty Swallowing
- Mouth/Throat Bleeding
- Painful Swallowing
- Persistent Neck Rigidity
- Repeated Nose Bleeds
- Ringing in Ears
- Toothache at Present
- None
- Neurologic (callout 7):
- Anxiety
- Balance Problems
- Confusion
- Depression
- Dizziness
- Headache
- Memory Loss
- Nervous Breakdown
- Numbness/Tingling
- Personality Changes
- Seizures
- Speech Changes
- None

- Head & Neck (callout 6):
- Step 4: Updated the symptom options for several health issues, including:
- Cardiovascular (callout 8):
- Ankle Swelling
- Chest Pain
- Circulation Problems
- Pacemaker/Defibrillator
- Palpitations
- Peripheral Edema
- High Blood Pressure
- Hypercholesterolemia
- Low Blood Pressure
- None
- Musculoskeletal (callout 9):
- Arthritis
- Back Pain
- Bone Pain
- Fractures
- Joint Stiffness
- Limited Motion
- Muscle Jerking
- Numbness
- Paralysis
- Problems Walking
- Swelling of Extremities
- Tingling Sensations
- Left-Sided Weakness
- Right-Sided Weakness
- None

- Cardiovascular (callout 8):
