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<clinician code='520646951' name='FORREST,ZACHARY H' role='A' taxonomyCode='203BS0130Y' providerType='Physicians (M.D. and D.O.)' classification='Physician/Osteopath' specialization='Surgery, Otorhinolaryngology &amp; Facial Plastic Surgery ' service='OIFO BAYPINES TEST LAB ' />
<clinician code='520646951' name='FORREST,ZACHARY H' role='S' dateTime='3150914.121349' signature='ZACHARY H FORREST physician tester' taxonomyCode='203BS0130Y' providerType='Physicians (M.D. and D.O.)' classification='Physician/Osteopath' specialization='Surgery, Otorhinolaryngology &amp; Facial Plastic Surgery' service='OIFO BAYPINES TEST LAB ' />
</clinicians>
<content xml:space='preserve'>
 LOCAL TITLE: HISTORY &amp; PHYSICAL
STANDARD TITLE: PHYSICIAN H &amp; P NOTE
DATE OF NOTE: SEP 14, 2015@12:12     ENTRY DATE: SEP 14, 2015@12:12:22
      AUTHOR: FORREST,ZACHARY H    EXP COSIGNER:
     URGENCY:                            STATUS: COMPLETED

Operation/ Procedure Scheduled: 9/14/2015

History of Present Illness:  Testing


Diagnosis: Testing

Current Medications: Active Outpatient Medications (excluding Supplies):

     Active Non-VA Medications                              Status
=========================================================================
1)   Non-VA ABSCESS ROOT CAP,ORAL  MOUTH EVERY DAY          ACTIVE
2)   Non-VA WORMWOOD OIL  AFFECTED AREA EVERY DAY           ACTIVE

Habits:
Alcohol, Tobacco, Drugs

Allergies:No Allergy Assessment

Relevant Past Medical History:
Review of Systems (explain positive findings)
Head and Neck No

Breasts (Female - Mammogram) No

Heart and Lungs Yes

Gastrointestinal No

Gentiourinary (Female - Pregnant) No

Musculoskeletal Yes

Peripheral Vascular Yes

Diabetes Yes

Psychiatric (Anxiety, depression) Yes

Other


Explanation of Positive Findings:
testing


Physical Examination:
Age: 30
Sex: FEMALE
Race: BLACK OR AFRICAN AMERICAN
Temperature: 111 F [43.9 C] (06/02/2015 11:25)
Pulse:45 (06/02/2015 11:25)
Respiration: 100 (01/15/2015 09:27)
B/P: 100/87 (06/02/2015 11:25)
Skin:test
Head and Neck: test

Adenopathy:test
Breasts: test
Cardiopulmonary:test
Abdomen: test
Rectal (Guaiac):test
Peripheral Vascular:test
Musculoskeletal: test
Neurological: test
Mental Status: test
Other Comments: test

Impression/Plan: test


Patient understands risks and benefits and wishes to proceed.

Appropriate Operative Site verified and marked in holding area:
Yes, No

There have been no significant changes in the history and physical done
preoperatively.  This patient is an appropriate candidate for the scheduled
surgery.

The patient has given approval to discuss his/her surgical care/findings
with family member(s) and/or accompanying party present.
Yes

/es/ ZACHARY FORREST
physician tester
Signed: 09/14/2015 12:13
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<clinician code='520647004' name='MCCARTHY,MOIRA C' role='A' taxonomyCode='203BS 0130Y' providerType='Physicians (M.D. and D.O.)' classification='Physician/Osteo path' specialization='Surgery, Otorhinolaryngology &amp; Facial Plastic Surgery' service='OIFO BAYPINES TEST LAB ' />
<clinician code='520647004' name='MCCARTHY,MOIRA C' role='S' dateTime='3150817.151524' signature='MOIRA C MCCARTHY ' taxonomyCode='203BS0130Y' providerType='Phy sicians (M.D. and D.O.)' classification='Physician/Osteopath' specialization='Surgery, Otorhinolaryngology &amp; Facial Plastic Surgery' service='OIFO BAYPINES TEST LAB ' />
</clinicians>
<content xml:space='preserve'>
 LOCAL TITLE: HISTORY &amp; PHYSICAL
STANDARD TITLE: PHYSICIAN H &amp; P NOTE
DATE OF NOTE: AUG 17, 2015@15:14     ENTRY DATE: AUG 17, 2015@15:14:48
      AUTHOR: MCCARTHY,MOIRA C     EXP COSIGNER:
     URGENCY:                            STATUS: COMPLETED

Operation/ Procedure Scheduled:

History of Present Illness:

Diagnosis:

Current Medications: Active Outpatient Medications (excluding Supplies):

     Active Non-VA Medications                              Status
=========================================================================
1)   Non-VA ABSCESS ROOT CAP,ORAL  MOUTH EVERY DAY          ACTIVE
2)   Non-VA WORMWOOD OIL  AFFECTED AREA EVERY DAY           ACTIVE

Habits:


Allergies:No Allergy Assessment

Relevant Past Medical History:
Review of Systems (explain positive findings)
Head and Neck

Breasts (Female - Mammogram)

Heart and Lungs

Gastrointestinal

Gentiourinary (Female - Pregnant)

Musculoskeletal

Peripheral Vascular

Diabetes

Psychiatric (Anxiety, depression)

Other


Explanation of Positive Findings:


Physical Examination:
Age: 30
Sex: FEMALE
Race: BLACK OR AFRICAN AMERICAN
Temperature: 111 F [43.9 C] (06/02/2015 11:25)
Pulse:45 (06/02/2015 11:25)
Respiration: 100 (01/15/2015 09:27)
B/P: 100/87 (06/02/2015 11:25)
Skin:
Head and Neck:
Adenopathy:
Breasts:
Cardiopulmonary:
Abdomen:
Rectal (Guaiac):
Peripheral Vascular:
Musculoskeletal:
Neurological:
Mental Status:
Other Comments:

Impression/Plan:

Patient understands risks and benefits and wishes to proceed.

Appropriate Operative Site verified and marked in holding area:


There have been no significant changes in the history and physical done
preoperatively.  This patient is an appropriate candidate for the scheduled
surgery.

The patient has given approval to discuss his/her surgical care/findings
with family member(s) and/or accompanying party present.


/es/ MOIRA C MCCARTHY

Signed: 08/17/2015 15:15
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<clinician code='520646951' name='FORREST,ZACHARY H' role='A' taxonomyCode='203B S0130Y' providerType='Physicians (M.D. and D.O.)' classification='Physician/Oste opath' specialization='Surgery, Otorhinolaryngology &amp; Facial Plastic Surgery ' service='OIFO BAYPINES TEST LAB ' />
<clinician code='520646951' name='FORREST,ZACHARY H' role='S' dateTime='3150306.102423' signature='ZACHARY H FORREST physician tester' taxonomyCode='203BS0130Y' providerType='Physicians (M.D. and D.O.)' classification='Physician/Osteopath' specialization='Surgery, Otorhinolaryngology &amp; Facial Plastic Surgery' service='OIFO BAYPINES TEST LAB ' />
</clinicians>
<content xml:space='preserve'>
 LOCAL TITLE: HISTORY &amp; PHYSICAL
STANDARD TITLE: PHYSICIAN H &amp; P NOTE
DATE OF NOTE: MAR 06, 2015@10:22     ENTRY DATE: MAR 06, 2015@10:22:24
      AUTHOR: FORREST,ZACHARY H    EXP COSIGNER:
     URGENCY:                            STATUS: COMPLETED

CC:

HISTORY OF PRESENT ILLNESS:

PAST MEDICAL HISTORY:

N
MEDS: Active Outpatient Medications (excluding Supplies):

     Active Non-VA Medications                              Status
=========================================================================
1)   Non-VA ABSCESS ROOT CAP,ORAL  MOUTH EVERY DAY          ACTIVE
2)   Non-VA WORMWOOD OIL  AFFECTED AREA EVERY DAY           ACTIVE

ALL:  No Allergy Assessment

FAMILY HISTORY:

)
SOCIAL HISTORY:

ROS:  (-)for wt loss, SOB, CP, N, V, D, melena, hematochezia, cough,
fever, chills, dysphagia, dysuria

.
PHYSICAL EXAMINATION:

VS:  PULSE              160 (02/02/2015 12:41)
     BLOOD PRESSURE     120/ (01/15/2015 09:27)
     RESPIRATION        100 (01/15/2015 09:27)
     TEMPERATIRE        98 F [36.7 C] (02/02/2015 12:41)
     SATS

N
GENERAL:  Patient alert and oriented, appears in NAD, is pleasant and
cooperative.

HEENT:  NCAT, PERRLA, EOMI, Posterior Oropharynx Clear, Neck Supple, no
lymphadenopathy, no thyromegaly

)
CHEST:  CTA Bilaterally, no wheezes, rales, or rhonchi, distant breath
sounds, barrel chested

CV:  RRR without murmur or gallop, distant heart sounds, nl S1 S2, no
carotid bruits

ABD:  NABS, soft, NDNT, no HSM, no mass

EXT:  No clubbing, no edema, good pulses

SKIN: No obvious lesions, no rash, dry skin

NEURO:  CN II-XII intact, motor strength 5/5 sensory intact.  Romberg neg,
gait steady, DTR&apos;s normal

GU/RECTAL:  Normal male anatomy, good rectal tone, prostate not enlarged,
heme negative stools

LABS:

CXR: No infiltrate, no effusion, no pneumothorax, normal heart size

EKG: No ST changes, normal sinus rhythm, no evidence acute MI

DIAGNOSIS TREATED, OR THAT REQUIRE FURTHER TREATMENT:

REASON FOR ORDERING TESTS, CONSULTS OR CHANGES IN MEDICATIONS:

ASSESSMENT/PLAN: (including follow-up treatment and patient instructions)

/es/ ZACHARY FORREST
physician tester
Signed: 03/06/2015 10:24
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<clinician code='520646951' name='FORREST,ZACHARY H' role='A' taxonomyCode='203B S0130Y' providerType='Physicians (M.D. and D.O.)' classification='Physician/Oste opath' specialization='Surgery, Otorhinolaryngology &amp; Facial Plastic Surgery ' service='OIFO BAYPINES TEST LAB ' />
<clinician code='520646951' name='FORREST,ZACHARY H' role='S' dateTime='3150306.10204' signature='ZACHARY H FORREST physician tester' taxonomyCode='203BS0130Y' providerType='Physicians (M.D. and D.O.)' classification='Physician/Osteopath' specialization='Surgery, Otorhinolaryngology &amp; Facial Plastic Surgery' service='OIFO BAYPINES TEST LAB ' />
</clinicians>
<content xml:space='preserve'>
 LOCAL TITLE: HISTORY &amp; PHYSICAL
STANDARD TITLE: PHYSICIAN H &amp; P NOTE
DATE OF NOTE: MAR 06, 2015@10:16     ENTRY DATE: MAR 06, 2015@10:17:03
      AUTHOR: FORREST,ZACHARY H    EXP COSIGNER:
     URGENCY:                            STATUS: COMPLETED

CC:

HISTORY OF PRESENT ILLNESS:

PAST MEDICAL HISTORY:

N
MEDS: Active Outpatient Medications (excluding Supplies):

     Active Non-VA Medications                              Status
=========================================================================
1)   Non-VA ABSCESS ROOT CAP,ORAL  MOUTH EVERY DAY          ACTIVE
2)   Non-VA WORMWOOD OIL  AFFECTED AREA EVERY DAY           ACTIVE

ALL:  No Allergy Assessment

FAMILY HISTORY:

)
SOCIAL HISTORY:

ROS:  (-)for wt loss, SOB, CP, N, V, D, melena, hematochezia, cough,
fever, chills, dysphagia, dysuria

.
PHYSICAL EXAMINATION:

VS:  PULSE              160 (02/02/2015 12:41)
     BLOOD PRESSURE     120/ (01/15/2015 09:27)
     RESPIRATION        100 (01/15/2015 09:27)
     TEMPERATIRE        98 F [36.7 C] (02/02/2015 12:41)
     SATS

N
GENERAL:  Patient alert and oriented, appears in NAD, is pleasant and
cooperative.

HEENT:  NCAT, PERRLA, EOMI, Posterior Oropharynx Clear, Neck Supple, no
lymphadenopathy, no thyromegaly

)
CHEST:  CTA Bilaterally, no wheezes, rales, or rhonchi, distant breath
sounds, barrel chested

CV:  RRR without murmur or gallop, distant heart sounds, nl S1 S2, no
carotid bruits

ABD:  NABS, soft, NDNT, no HSM, no mass

EXT:  No clubbing, no edema, good pulses

SKIN: No obvious lesions, no rash, dry skin

NEURO:  CN II-XII intact, motor strength 5/5 sensory intact.  Romberg neg,
gait steady, DTR&apos;s normal

GU/RECTAL:  Normal male anatomy, good rectal tone, prostate not enlarged,
heme negative stools

LABS:

CXR: No infiltrate, no effusion, no pneumothorax, normal heart size

EKG: No ST changes, normal sinus rhythm, no evidence acute MI

DIAGNOSIS TREATED, OR THAT REQUIRE FURTHER TREATMENT:

REASON FOR ORDERING TESTS, CONSULTS OR CHANGES IN MEDICATIONS:

ASSESSMENT/PLAN: (including follow-up treatment and patient instructions)

/es/ ZACHARY FORREST
physician tester
Signed: 03/06/2015 10:20
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<clinician code='520646951' name='FORREST,ZACHARY H' role='A' taxonomyCode='203B S0130Y' providerType='Physicians (M.D. and D.O.)' classification='Physician/Oste opath' specialization='Surgery, Otorhinolaryngology &amp; Facial Plastic Surgery ' service='OIFO BAYPINES TEST LAB ' />
<clinician code='520646951' name='FORREST,ZACHARY H' role='S' dateTime='3110804.11' signature='ZACHARY H FORREST physician tester' taxonomyCode='203BS0130Y' providerType='Physicians (M.D. and D.O.)' classification='Physician/Osteopath' specialization='Surgery, Otorhinolaryngology &amp; Facial Plastic Surgery' service='OIFO BAYPINES TEST LAB ' />
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<content xml:space='preserve'>
 LOCAL TITLE: HISTORY &amp; PHYSICAL
STANDARD TITLE: PHYSICIAN H &amp; P NOTE
   DICT DATE: AUG 04, 2010@11:00     ENTRY DATE: MAR 06, 2015@10:16:07
 DICTATED BY: FORREST,ZACHARY H    EXP COSIGNER:
     URGENCY:                            STATUS: COMPLETED

CC:

HISTORY OF PRESENT ILLNESS:

PAST MEDICAL HISTORY:

N
MEDS: Active Outpatient Medications (excluding Supplies):

     Active Non-VA Medications                              Status
=========================================================================
1)   Non-VA ABSCESS ROOT CAP,ORAL  MOUTH EVERY DAY          ACTIVE
2)   Non-VA WORMWOOD OIL  AFFECTED AREA EVERY DAY           ACTIVE

ALL:  No Allergy Assessment

FAMILY HISTORY:

)
SOCIAL HISTORY:

ROS:  (-)for wt loss, SOB, CP, N, V, D, melena, hematochezia, cough,
fever, chills, dysphagia, dysuria

.
PHYSICAL EXAMINATION:

VS:  PULSE              160 (02/02/2015 12:41)
     BLOOD PRESSURE     120/ (01/15/2015 09:27)
     RESPIRATION        100 (01/15/2015 09:27)
     TEMPERATIRE        98 F [36.7 C] (02/02/2015 12:41)
     SATS

N
GENERAL:  Patient alert and oriented, appears in NAD, is pleasant and
cooperative.

HEENT:  NCAT, PERRLA, EOMI, Posterior Oropharynx Clear, Neck Supple, no
lymphadenopathy, no thyromegaly

)
CHEST:  CTA Bilaterally, no wheezes, rales, or rhonchi, distant breath
sounds, barrel chested

CV:  RRR without murmur or gallop, distant heart sounds, nl S1 S2, no
carotid bruits

ABD:  NABS, soft, NDNT, no HSM, no mass

EXT:  No clubbing, no edema, good pulses

SKIN: No obvious lesions, no rash, dry skin

NEURO:  CN II-XII intact, motor strength 5/5 sensory intact.  Romberg neg,
gait steady, DTR&apos;s normal

GU/RECTAL:  Normal male anatomy, good rectal tone, prostate not enlarged,
heme negative stools

LABS:

CXR: No infiltrate, no effusion, no pneumothorax, normal heart size

EKG: No ST changes, normal sinus rhythm, no evidence acute MI

DIAGNOSIS TREATED, OR THAT REQUIRE FURTHER TREATMENT:

REASON FOR ORDERING TESTS, CONSULTS OR CHANGES IN MEDICATIONS:

ASSESSMENT/PLAN: (including follow-up treatment and patient instructions)

/es/ ZACHARY FORREST
physician tester
Signed: 08/04/2011 11:00
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<clinician code='520646951' name='FORREST,ZACHARY H' role='A' taxonomyCode='203BS0130Y' providerType='Physicians (M.D. and D.O.)' classification='Physician/Osteopath' specialization='Surgery, Otorhinolaryngology &amp; Facial Plastic Surgery' service='OIFO BAYPINES TEST LAB ' />
<clinician code='520646951' name='FORREST,ZACHARY H' role='S' dateTime='3141223.122744' signature='ZACHARY H FORREST physician tester' taxonomyCode='203BS0130Y' providerType='Physicians (M.D. and D.O.)' classification='Physician/Osteopath' specialization='Surgery, Otorhinolaryngology &amp; Facial Plastic Surgery' service='OIFO BAYPINES TEST LAB ' />
</clinicians>
<content xml:space='preserve'>
 LOCAL TITLE: AMB CARE PAST,FAMILY &amp; SOCIAL HISTORY FORM (TEMPLAT
STANDARD TITLE: H &amp; P NOTE
DATE OF NOTE: DEC 23, 2014@12:26     ENTRY DATE: DEC 23, 2014@12:27:06
      AUTHOR: FORREST,ZACHARY H    EXP COSIGNER:
     URGENCY:                            STATUS: COMPLETED

Patient:  NWHINZZZTESTPATIENT,NWHINFIVE
Social Security Number:  666-10-0005
Date of Birth:  JAN 5,1985
Date: DEC 23, 2014 12:27

Past Medical History

A.  Have you experienced or been treated for any of the following
conditions?

1.  Headaches or a nervous disorder                     _x__YES    ___NO
2.  Thyroid disorder                                    _x__YES    ___NO
3.  Heart condition                                     ___YES    __x_NO
4.  High blood pressure                                 _x__YES    ___NO
5.  Lung disorder                                       ___YES    __x_NO
6.  Breast problems                                     __x_YES    ___NO
7.  Jaundice, hepatitis or other liver disorder         __x_YES    ___NO
8.  Stomach, bowel, or gallbladder problems             ___YES    _x__NO
9.  Female or sexual problems                           _x__YES    ___NO
10. Anemia or drug loss                                 ___YES    ___NO
12. Have you ever received a blood transfusion          _x__YES    ___NO
13. Diabetes                                            _x__YES    ___NO
14. Cancer                                              ___YES    _x__NO
15. Other medical problems                              _x__YES    ___NO

B.  Are you taking any medications at present?          ___YES    _x__NO
       If yes, please list below.

NAME OF DRUG                            PRESCRIBING DOCTOR



C.  Are you Allergic to any medications?                ___xYES    ___NO
        If yes, please list below.

    IBUPROFEN, SUNLIGHT

D.  Hospitalizations

MONTH/YEAR                              REASON

/es/ ZACHARY FORREST
physician tester
Signed: 12/23/2014 12:27
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