• Biographic data • Chief complaint • Past and current health care • Past surgeries • Family’s health history • Psychosocial history • Activities of daily living • Medications and drugs • Signs or symptoms of abuse

· Head – headaches, injuries Eyes – vision, glasses, glaucoma, cataracts, tearing or drainage, blurred/ double vision, dry, itchy or burning eyes Ears – hearing, hearing aids, pain or swelling, discharge Nose – breathing or smelling difficulties; sinusitis or nosebleeds Mouth and throat – dentures, sores or dryness, taste, toothaches or bleeding gums, throat soreness or swallowing issues Neck – swelling, soreness, stiffness or pain Respiratory – shortness of breath, pain or wheezing, cough, pneumonia, asthma, emphysema, respiratory tract infections Cardiovascular – chest pain, palpitations, irregular heartbeat, shortness of breath, hypertension, varicose veins, pain in legs, pacemaker Breasts – lumps, changes in breast or nipples, pain, discharge Gastrointestinal – weight changes, bowel movements, laxative use, nausea, vomiting, heartburn, abdominal pain, belching, passing of gas, hemorrhoids, rectal bleeding, hernias, gallbladder or liver disease

· Renal – color of urine, burning, incontinence, urgency, retention, flow and kidney stones Reproductive (women) – menstruation and menopause, pregnancies, birth control, PAP tests, vaginal infections, STDs Reproductive (men) – prostate, STDs, birth control or vasectomy, penile pain, discharge or lesions, testicular lumps Musculoskeletal – balance, difficult walking, sitting or standing, arthritis, gout, back injury, muscle weakness, paralysis or joint pain, fractures Neurologic – tremors, twitching, numbness, tingling, or loss of sensation, seizures, memory loss Endocrine – fatigue or tiredness, hunger and thirst, weight loss or gain, tolerance of heat and cold, hair loss or changes Hematologic – anemia, blood abnormalities or transfusions, fatigue, bruising or bleeding Psychological – mood swings, anxiety, depression, concentration, stress and coping