History

************* PATIENT MEDICAL HISTORY ********************

Based on information received from dispatch, on-scene, and during transport, it was the author’s understanding that the patient had a medical history of ____________________.

At the time of transport, the reported medications for the patient were ________________.

The pt was reported to have allergies __________________________________.

The patient was treated as ___ during transport because the documents presented to the crew did __ include either a fully executed POLST, fully executed advanced healthcare directive, fully executed EMSA/CMA Prehospital Do Not Resuscitate Form, or a DNR medallion from an approved medallion provider. 

************ HISTORY OF PRESENT ILLNESS ***************

It was reported that before the arrival of crew on scene  ______________________

************* COURSE OF TREATMENT *********************