“Are you allergic to anything, food or medicine?”
“Are you taking any medications? Prescribed or over the counter?
HITS (Hospitalizations, Injuries, trauma, Surgeries)Doc:
“Have you ever been hospitalized? Any surgeriesin the past? Any injuries or accidents? Have you ever received transfusions?”
“Have you noticed any changes in your Urinary Habits?”
“What about in your Bowel Movements?”
“Are you sleeping ok?
W Weight: Have you had any significant change inyour weight recently? A Apetite: Have you had any change in your appetite? T Travel: Did you have any recent travel
Before Family Hx
“Now I am going to ask you some qs about your Family’s health” “ F (Family Hx)Doc:
Does anybody in your family have the same problem? Are there any medical conditions that run in your family? like Diabetes, High blood pressure,Cancer? “Are your parents healthy?”
Before Obstetric Hx “Now I am going to ask you some qs about your Obstetric Hx Ok? O (Obstetric Hx)Doc:
When did you have your first menstrual period?
“When was your last menstrual period LMP? Was it regular?
“How many times have you being pregnant? Any abnormalities or complications? Any miscarriages? At how many weeks?
“How many children do you have? Are they healthy?
“What are you using for birth control?”
Before Sexual History “Ok Mr. Smith, now I am going to ask you some very personal qs, but let me re-assure you that everything we talk will be kept confidential ok?” S (Sexual history)Doc:
“Are you sexually active?”
“In the last year how many sexual partners haveyou had? Are they male, female, or both?”
“Have you noticed any changes in your sexual function?
“Do you always use condoms?” “Have you ever had any STD Sexual transmitted disease? Did you get any treatment? And your sexual partner?
Before Social History Doc: “Now let me ask you some qs about your lifestyle” S (Social history) L SODA WET L
“Who do you Live with?”
“Do you smoke?” How many packs a day? For how many years?
“Do you drink Alcohol? What do you drink? How
many glasses, beers a day, how many days a week?
“Do you use any recreational drugs? What do you
use? When was the last time you had it?
“How is your appetite? How is your diet? Any recent weight changes? How many pounds? Over what period of time?”
“What kind of work do you do?” Is it stressful?
“How often do you exercise?”
“Have you recently traveled?”