Review of Systems General
Review of Systems General
--------------------------------------------------------------------------------------------------------------------Eyes Vision
Glasses or contacts
Pain
Redness
Blurry or double vision
Flashing lights
Specks
Glaucoma
Cataracts
Last eye exam
--------------------------------------------------------------------------------------------------------------------Nose Stuffiness
Discharge
Itching
Hay fever
Nosebleeds
Sinus pain
--------------------------------------------------------------------------------------------------------------------Throat Teeth
Gums
Bleeding
Dentures
Sore tongue
Dry mouth
Sore throat
Hoarseness
Thrush
Non-healing sores
Last dental exam
--------------------------------------------------------------------------------------------------------------------Neck Lumps
Swollen glands
Pain
Stiffness
--------------------------------------------------------------------------------------------------------------------Breasts Lumps
Pain
Discharge
Self-exams
Breast-feeding
--------------------------------------------------------------------------------------------------------------------Respiratory Cough (dry or wet, productive)
Sputum (color and amount)
---------------------------------------------------------------------------------------------------------------------
Urinary Frequency
Urgency
Burning or pain
Blood in urine (hematuria)
Incontinence
Change in urinary strength
--------------------------------------------------------------------------------------------------------------------GenitalMale Pain with sex
Hernia
Penile discharge
Sores
Masses or pain
Erectile dysfunction
STDs
Female Pain with sex
Vaginal dryness
Hot flashes
Vaginal discharge
Itching or rash
STDs
---------------------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------------------