SOAP Multiple Issues
A professional Family Medicine template for healthcare professionals.
Preview template
Chief complaint 1
(Include relevant history and associated information in chronological order) 1) [Chief complaint 1] - [Hyphenated list of symptoms and related history]
Chief complaint 2
2) [Chief complaint 2] - [Hyphenated list of symptoms and related history]
Additional chief complaints
[etc...]
Objective details
(hyphenated list) - [Vital signs with units in one line] (e.g., HR: #, BP: #, T: #, RR: #, O2 sats: #%) - [Physical exam findings and/or mental status exam findings directly examined] (Format as "System: Exam findings", one system per line. Specify anatomical location if relevant) - [Investigation results with units] (Only include completed investigations, otherwise leave blank. All planned or ordered investigations should be included under Plan)
Assessment and Plan details
(Do not fabricate the assessment and plan unless mentioned in the source material. Use medical terminology if appropriate. Each assessment and plan number should correlate directly with the subjective section) 1) [Diagnosis 1 and rationale if mentioned] - [Hyphenated plan] 2) [Diagnosis 2 and rationale if mentioned] - [Hyphenated plan] - [Follow up plan] - [Return precautions] [etc…]
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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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