1.
Education and Self-Care Capability
2.
Prior Screening Test History
3.
Nutrition, Drug, and Alcohol Related Risks
4.
Exercise and Activity Habits
5.
Smoke and Environmental Risks
6.
Behavior Risks (ie. Safety Habits
)
7.
Mental Stress and Sleep History
8.
Immunization History
9.
Current Health Status (Review of Systems)
10. Prior Medical Visit History