HPI Template

.hpi

Patient Name:
Full Name

Age:
Patient's Age

Date of Visit:
MM/DD/YYYY


Chief Complaint (CC):
Patient's primary concern


History of Present Illness (HPI):
- Onset:
When did the symptoms start?

- Location:
Where are the symptoms located?

- Duration:
How long have the symptoms been present?

- Character:
What is the nature of the symptoms?

- Aggravating factors:
What makes the symptoms worse?

- Relieving factors:
What alleviates the symptoms?

- Timing:
Are the symptoms constant or intermittent?

- Severity:
How severe are the symptoms on a scale of 1 to 10?
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