Dizziness and fainting spells
[DOC File]SAMPLE MEBR FOR PEB - CHAPTER 18
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midline occipital headaches, occurs in the AM upon awakening, resolves with aspirin, chronicity 11 years; dizziness and fainting spells, episode duration approximately 2 minutes, chronicity 7 years, associated with gastro-intestinal symptoms, no known loss of consciousness. Gastrointestinal:
[DOC File]North Wilkesboro Dentist, Wilkes Public Health Dental ...
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5. Yes No Chest pain (angina) 11. Yes No Dizziness/Fainting spells. 6. Yes No Recent weight loss, fever, night sweats 12. Yes No Headaches/Migraines. 7. Yes No Persistent cough, coughing up blood 13. Yes No Seizures. 8. Yes No Blood Disease, bleeding problems, bruising easily 14. Yes No Excessive thirst/Dry mouth. 9.
[DOC File]CIVIL AIR PATROL
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Decreased vision, glaucoma, contacts Chronic or recurring injuries Ear infections, perforation Activity, mobility restrictions Difficulty equalizing ears Use of cane, walker, wheelchair Hearing loss, hearing aid Back or neck pain or injury Allergies, nasal stuffiness Migraine or severe headaches Anaphylaxis, serious allergic reaction Dizziness ...
[DOC File]PRESENT ILLNESS:
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Gastrointestinal Dizziness/fainting spells Now In Past. Ulcers/stomach trouble Now In Past Epilepsy/seizures Now In Past. Black/tarry bowel movementsNow In Past Psychological Bright red bowel movements Now In Past Excessive worry/nervousness Now In Past. Unusual constipation: Now In Past Depression/nervous disorder Now In Past
[DOCX File]Microsoft Word - Keays Medical Group
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Dizziness . i. Fainting spells. j. Feeling your heart pound or race. k. Shortness of breath. l. Constipation, loose bowels, or diarrhea. m. Nausea, gas, or indigestion. 2. Over the last . 2 weeks, how often have you been bothered by any of the following problems? Not at All. Several Days.
[DOC File]Exercise Basics - BCBSIL
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Do you have fainting spells or extreme dizziness? Have you had chest pain within the past month? Do you have a bone or joint problem that is. aggravated by physical activity? Are you aware of any problems that might make. exercise harmful to your health? Exercise Q & A.
MEDICAL SCREENING FOR CIVILIAN EMBARKATION ABOARD A UNITED ...
Dizziness, fainting spells or passing out (9) Asthma, wheezing, shortness of breath or inhaler use. (46) Heat stroke, exhaustion or tendency. (10) Collapsed lung or other lung condition (47) Motion sickness (car, boat, air) (11) Pneumonia or bronchitis (48)
[DOCX File]National Emergency Services Academy
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Dizziness or Fainting Spells. Unconsciousness for any reason. Eye trouble, excluding glasses or contacts. Epilepsy or fits. Hay Fever. Motion Sickness. Heart Trouble. Nervous Trouble of any sort. High or Low Blood Pressure. Any Known Allergies. Stomach Trouble. Asthma. Chronic or Recurring Injuries.
[DOT File]FM Health History Form
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Dizziness. Fainting Spells. Blackouts/Amnesia. Had prior shock therapy. Frequently keyed up and jittery. Startled by sudden noises. Anxiety/Feeling of panic. Go to pieces easily. Forgetful. Listless/groggy. Withdrawn feeling/Feeling ‘lost’ Had nervous breakdown. Unable to concentrate/short attention span. Vision changes. Unable to reason
[DOCX File]EMERGENCY FACT SHEET
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____ ____ Does your child have a history of dizziness or fainting spells? ____ ____ Does your child have a bone or joint problem that is aggravated by exercise, or may be made worse with exercise? If yes what type of injury/condition occurred and when?
[DOC File]PBM Drug Monograph Template
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Caution should be used when treating patients with a history of syncope, patients receiving medications known to be associated with hypotension, and patients who are dehydrated. Patients should be instructed to seek medical advice if they experience symptoms of dizziness, light-headedness or fainting spells.
[DOC File]PHQ -15
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PHQ -15. A 15 item Somatic Symptom Severity Scale. During the past four weeks, how much have you been bothered by any of the following problems Not bothered at all Bothered a little Bothered a lot Stomach pain Back pain Pain in your arms or legs or other joints Menstrual cramps or other problems with your periods (women only) Headaches Chest Pain Dizziness Fainting spells Feeling your heart ...
[DOC File]TMJ Patient History Form
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Dizziness? Ringing in ears? Fainting spells? Grating noises in ears? Nausea? Feel or hear “clicking” or “popping” in jaw joint? Grinding/Clenching at night? Family history of jaw (TMJ) problems? Headaches in back of head or neck area? Fatigued jaw after meal? Headaches in temple areas?
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