Procedure Note

Summary: [brief overview of the indication, procedure performed, any other management] Subjective: • [description of presenting complaint, including location and duration] • [any other history obtained from the patient] Objective: • [physical exam findings] Assessment: • [diagnosis or differential diagnoses] Management: • Procedure: [name of procedure performed using sterile technique] ├ [discussion of risks; specifically list all risks that were discussed and whether informed consent was obtained] └ [describe the details of the procedure] • [any post-procedure instructions that were given to the patient] • [instructions for follow up, including timing and reason] Title: [a title for the note summarizing the important information] ICD-9 Code: [relevant ICD-9 codes] (use "• " to indicate list items, and, if necessary, use "├ " to indicate sub-items in lists, and "└ " to indicate sub-sub items, etc.) (Never come up with your own patient details, assessment, plan, interventions, evaluation, and plan for continuing care - use only the transcript, contextual notes, or clinical note as a reference for the information included in your note. If any information related to a placeholder has not been explicitly mentioned in the transcript, contextual notes, or clinical note, you must not state the information has not been explicitly mentioned in your output, just leave the relevant placeholder or section blank.)