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CHART #: HPI New Patient PATIENT NAME: LAST FIRST MIDOB: HISTORY OF PRESENT ILLNESS (HPI) Chief Complaint (In your own words) Why are you here today? Are you currently pregnant? Yes No Possibly Are.

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How to fill out the HPI New Patient online

Filling out the HPI New Patient form is an essential step in addressing your health concerns. This guide is designed to help you complete the form accurately and efficiently, ensuring that your healthcare provider has all the information needed for your first visit.

Follow the steps to complete the HPI New Patient form successfully.

  1. Press the ‘Get Form’ button to access the HPI New Patient form and open it in the designated editor.
  2. Begin by entering your full name in the specified fields for last name, first name, and middle initial.
  3. Provide your date of birth in the format MM-DD-YYYY.
  4. In the 'History of Present Illness' section, describe your chief complaint in your own words under 'Why are you here today?'. Be as specific and clear as possible.
  5. Indicate your pregnancy status by selecting ‘Yes’, ‘No’, or ‘Possibly’.
  6. Answer the questions regarding your current pain by selecting ‘Yes’ or ‘No’. If applicable, check if your problem wakes you from sleep.
  7. Identify any daily activities that may be limited due to your problem by checking the relevant options.
  8. In the ‘Location’ section, specify the extremity you are being evaluated for and indicate the side of your body as left, right, or both.
  9. Describe the quality of your problem or pain by checking all that apply from the list provided.
  10. Rate the severity of your pain on a scale from 1 to 10, providing the corresponding number.
  11. Indicate the date of injury or the date symptoms began.
  12. Describe the timing of your problem or pain by selecting the appropriate option.
  13. In the 'Context' section, indicate where your injury first occurred and describe the situation at that time.
  14. List what helps alleviate your pain by selecting the relevant options.
  15. Provide details on any medications you are currently taking for pain.
  16. Identify any factors that seem to aggravate your pain.
  17. Mention any associated signs and symptoms that have developed as a result of your issue.
  18. If applicable, provide details about any tests that have been conducted and the impact of previous treatments on your condition.
  19. Once all sections are completed, ensure you review your entries for accuracy, then save, download, print, or share the completed form as needed.

Complete your HPI New Patient form online today to ensure a smooth and efficient healthcare experience.

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The HPI is a chronological description of the development of the patient's present illness from the first sign and/or symptom or from the previous encounter to the present. It includes the following elements: location; quality; severity; duration; timing; context; modifying factors; and associated signs and symptoms.

A 62-yr-old man comes to his primary care clinic with the chief complaint of chest pain. He has no pain currently. He first noticed the pain 2 mo ago but attributed it to indigestion. He describes the pain as a pressure sensation in the middle of his chest that does not radiate anywhere else.

HISTORY OF PRESENT ILLNESS (HPI) It includes the following elements: location; quality; severity; duration; timing; context; modifying factors; and associated signs and symptoms.

The HPI should be written in prose with full sentences and be a narrative that builds an argument for the reason the patient was admitted. Has a starting point (i.e. “the patient was in her usual state of health until 5 days prior to admission.). Has appropriate flow, continuity, sequence, and chronologic order.

Some examples include: fever and chills that accompany a chief complaint of stomach pain; sore throat and sinus pain that accompany a cough; numbness and tingling accompanying pain in the leg.

It includes the patient's age, gender, most pertinent past medical history and major symptoms(s) and duration. Whenever possible, this statement should identify the significant issue from the patient's perspective, and include the patient's words if the patient accurately represents the reason for the presentation.

History of Present Illness (HPI) The HPI is a chronological description of the development of the patient's present illness from the first sign and/or symptom or from the previous encounter to the present.

“Stephanie was playing soccer when she landed on her right foot and she heard a pop.” This indicates that “playing soccer” was the context. If the physician further indicated that “after she went to the bench she started to rub it and it felt better,” this would be a modifying factor.

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Fill HPI New Patient

Getting Started: Always introduce yourself to the patient. The HPI should be written in prose with full sentences and be a narrative that builds an argument for the reason the patient was admitted. This is the first admission for this 56 year old woman,. The HPI is usually a chronological description of the progression of the patient's present illness from the first sign and symptom to the present. Note "Refer to HPI" if question responses are documented in the HPI.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232