Continuity of Care Document 1234 Six Forks Portland OR 97005 US Everyman Adam Get Well Clinic Get Well Clinic 1004 Healthcare Dr. Portland OR 97005 US Get Well Clinic Get Well Clinic 1004 Healthcare Dr. Portland OR 97005 US Get Well Clinic 1004 Healthcare Dr. Portland OR 97005 US Get Well Clinic Get Well Clinic 1004 Healthcare Dr. Portland OR 97005 US Get Well Clinic 1004 Healthcare Dr. Portland OR 97005 US Khan Samir Dr Get Well Clinic 1004 Healthcare Dr. Portland OR 97005 US Nightingale Nancy RN 1047 Healthcare Drive Portland OR 97005 US Puffer Penny Dr
Reason For Referral Dr. Puffer please see this patient and evaluate by performing Pulmonary Function Tests
Functional Status Functional Status Health Issues
Name Dates Details
No Functional Impairment
Onset: 15-Aug-2012 Status:
Cognitive Status Health Issues
Name Dates Details
No Cognitive Impairment
Onset: 15-Aug-2012 Status:
Problems
Name Dates Details
Costochondritis
Onset: 15-Aug-2012 Status: Active
Asthma
Onset: 25-Sep-2011 Status: Active
Get Well Clinic 1004 Healthcare Dr. Portland OR 97005 US Khan Samir Dr
Medications
Name Dates Details
Albuterol 0.09 MG/ACTUAT metered dose
TWO PUFFS Q6H PRN AS DIRECTED.
Two puffs every six hours as needed for wheezing
Started 20-Feb-2012
Active
Proventil
Allergies and Adverse Reactions
Name Dates Details
Penicillin G benzathine Onset: 10-Jan-1998 Reaction: Hives
Status: Active
Codeine Onset: 10-Jan-2001 Reaction: Nausea
Status: Active
Get Well Clinic 1004 Healthcare Dr. Portland OR 97005 US Khan Samir Dr Penicillin G benzathine Codeine
Immunization
Name Dates Details
Influenza virus vaccine
Administered on: 15-Aug-2012 Site: Left Arm
Get Well Clinic 1004 Healthcare Dr. Portland OR 97005 US Nightingale Nancy RN
Social History Smoking Status Never smoker Started 2012 Current some day smoker Started 2012
Vital Signs
Date Test Result Details
15-Aug-2012
Height 70 in Status:
Weight 195 lb Status:
BP Systolic 150 mm[Hg] Status:
BP Diastolic 100 mm[Hg] Status:
Body Mass Index Calculated 28 Status:
Get Well Clinic 1004 Healthcare Dr. Portland OR 97005 US Khan Samir Dr
Results
Date Description Value Details
Resulted on:
15-Aug-2012 10:33 		CO2 25 mmol/L
Get Well Clinic 1004 Healthcare Dr. Portland OR 97005 US Nightingale Nancy RN
Plan of Care Planned Observations
Name Dates Details
Goal: Weight Loss On 15-Aug-2012
Goal
Goal: Asthma Management On 15-Aug-2012
Goal
Planned Encounters
Pulmonary function Tests
Encounter Reason: Pulmonary function Tests (reason) Dr. Penny Puffer Office - need office address

Puffer, Penny Dr 		On 1-Feb-2013
00:00
1047 Healthcare Drive Portland OR 97005 US Puffer Penny Dr Dr. Penny Puffer Office - need office address
Get Well Clinic 1004 Healthcare Dr. Portland OR 97005 US Khan Samir Dr
Instructions Asthma Management resources and instructions provided during admission diet and exercise counseling material provided during visit
Encounters
Offie Visit
Encounter Diagnosis: Costochondritis Active Get Well Clinic

Khan, Samir Dr 		On 15-Aug-2012
09:00
Get Well Clinic 1004 Healthcare Dr. Portland OR 97005 US Khan Samir Dr Get Well Clinic