Patient Health Profile

Page 1

PATIENT PROFILE Patient Demographics Name: ​Margo Shaw Sex: ​Female Gender: ​Gender Fluid Age: ​16 years Height: ​5’ 4’’ Weight: ​137 lbs. Medical History: ​Patient has anxiety, depression, history of self-harm and suicidal urges and one attempt. Patient also has Osgood-Schlatter, insomnia, and unexplained migraines. They are allergic to soy and have seasonal allergies. Medications: ​Patient takes antidepressant SSRIs and birth control to lower pain during menstrual cycles. Lifestyle Behaviors: ​Patient eats well, with 3 regular meals a day and flaxseed every morning. They work out about 2-3 times a week and walk about 2 miles everyday for their commute. Medical Concerns/Family History:​ Patient’s family has history of breast cancer, insomnia, arthritis, osgood-schlatter and heart and blood disease. Purpose of Consultation: ​Patient is concerned about their risk for breast cancer as it is fairly common in their family and runs on both sides of the family.


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Patient Health Profile by MDS GCE - Issuu