February 21, 2007

MedicalTemplates - Asthma Encounter Form

MedicalTemplates has developed a 1 page asthma patient evaluation template. This template is suitable for any health care provider that manages patients with asthma.

The asthma patient template contains prompters and space for the following required elements for a E&M encounter -

  • Chief complaint

  • History of present illness

  • Past medical and surgical history

  • Social history

  • Family history

  • Review of systems

  • Review of data (labs, tests, imaging)

  • Physical exam

  • Assessment and plan



This one page template contains detailed checklists for the severity of asthma symptoms, current and planned asthma therapy, and other features helpful for a comprehensive asthma treatment plan.

The asthma patient encounter template was designed to include Clinical Performance Measures for Asthma developed by the Physician Consortium for Performance Improvement.

The Clinical Performance Measures for Asthma can be downloaded from here.

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