Current Situation

1. Problem Statement: Describe in a single sentence what’s bothering you. A3 Title Name /patient number/ email / phone Purpose Statement: Describe what your goal is for your treatment. What do you hope to get? For example, if you have high blood pressure, you may need to state that you want to minimize your use of drugs to achieve BP control. Symptoms Chart: Here is another Visual Model that I’ve found to be helpful. It can save a lot of time since it will answer a lot of the doctor’s questions about your recent symptoms – especially the ones you’re NOT having which can help rule out things. Current Situation Describe what’s happening with words and pictures. The timeline graphic below is one example of a visual model to explain the progression of a worsening condition. You can also use a picture of a body that you label to show where you have pain, or graphs to show your symptoms over time. Pain Map(showing lower back pain and sciatica) Timeline Other observations: When you LOOK at your health, what else do you observe about yourself? What about your energy level / caffeine intake? What’s changed about sleeping / eating and bodily functions? GREEN YELLOW Current Treatment Plan and Treatments for Other Conditions: What have you already done yourself at home? What have other doctors don or told you to do? What other medications / treatments are you on for other things that seem to be unrelated? Especially note anything that’s been tried that HASN’T made a difference. . RED