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Following this template Onset of Chronic Disease: Last Visit: what were the plans/goals/changes from the last visit? Lab results from prior visit Medication adjustments, changes, additions? Overview of disease-related adherence to lifestyle modifications, e.g. diet, exercise, tobacco etc. (specifics addressed in Social History) Medications: related to the diagnosis: include adherence, prn use, (effect and relief?) and possible medication side effects Home Readings: (home glucose, BP, peak flow meter etc.) Chronic disease specific screenings: (e.g. microalbumin, eye exam) Self-care: related to chronic disease: (e.g. DM—inspect feet, Insomnia—sleep hygiene, Depression—exercise, sunlight) Treatments: e.g., physical therapy, cardiac rehab, pulmonary rehab, massage, hot soaks, dressing changes, counseling. Patient perception: How is the patient/client feeling about their condition? What are their goals? Use open-ended questions. ask questions for a 3 year old black male follwing up for consitpaiton.

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