1. Chief Complaint:
History of Present Illness:
S Medical History:
Med Conditions
Medications
Allergies
Past Sx
Social Hx:
Tobacco
ETOH
Vitals: BP
HR
Temp
Clinical Exam
Extraoral: (Asymmetry, Swelling, Erythema, Pain, Parasthesia, TMJ)
Intraoral: (Swelling, Exudate, Erythema, Hemorrhage, Mobility, Occlusion, Pain, Biotype, Hard Tissues)
O Radiology: (PA, Pano, CT)
Endodontic Testing
Tests: #
Cold:
# # #
EPT:
Perc:
Palp:
Prob:
Mob:
Assessment:
A
Plan:
P Treatment Rendered Today: