Anxiety
A professional Pediatrics template for healthcare professionals.
Preview template
Chief Complaint
Anxiety
History of Present Illness
Anxiety [specific type of anxiety, e.g., selective mutism]
Past Medical History
Past Surgical History
Family History
[Family history details or 'None Recorded']
Social History
The Review of Systems
Current Medications
Allergies
Vital Signs
Weight: [weight] kg Height: [height] cm BP: [blood pressure] HR: [heart rate] bpm
Physical Examination
HEENT - [TM normal, neck supple, mmm, pharynx clear, no LAN] RESP - [clear bilat, no LAN, neck supple, mmm] CVS - [normal S1 and S2, no murmurs, good cap refill] ABD - [soft, non-tender, no hsm, no masses] MSK - [normal ROM, no joint swelling] CNS - [grossly normal] DERM - [no rash]
Test Results
Active Medications
[Active medications or 'None Recorded']
Problem
Differential Diagnosis
Plan
Plan
Impression/Plan
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How to use this template
This comprehensive new patient template helps establish care by capturing complete medical history, current concerns, and baseline health status. Use this for patients during their initial visit to create a thorough medical record.
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