Headaches with numbness and tingling
[DOCX File]CONFIDENTIAL PATIENT INFORMATION
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Other Important Physical Symptoms: ex. dyspnea, chest pain, headaches, numbness/tingling, weakness Social History: Alcohol/Tobacco/Drug Use: ex. current and past use?
[DOC File]Health Questionnaire for Massage Therapy
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Neck pain Headaches Sinusitis-Allergies Pain into your shoulders/arms/hands Dizziness Numbness/tingling in arms/hands Visual disturbances ... Numbness/tingling in your legs/feet Frequent/difficulty urinating
[DOC File]September 17, 1999 - Centra Health
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Avg. Pain Rating _____Self Reported Functional Rating _____Neck Disability Index: _____
[DOC File]PATIENT HISTORY FORM - Hopkins Medicine
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Numbness/tingling. Headaches. Stroke. Seizure disorder. Reduced sensation. Other:_____ Reproductive System. Breast cancer. Ovarian cysts. Painful menstruation. Pregnant . ... Sharp Dull ache Numbing Burning Tingling Shooting. Are your symptoms? Getting better Staying the same Getting worse. When is it worst? ...
[DOC File]CHMC Headache questionnaire - Cornell University
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Numbness Headache Tingling Swelling Tightness Weakness. Quality of Your Symptoms: Sharp Throbbing Burning Dull Local Tension ... Neck Pain Headaches Sinusitis/Allergies Pain into Shoulders/Arms/Hands Dizziness
Comprehensive Geriatric Assessment Template
**Fever or chills >3 days Flu-like symptoms Headaches (chronic) **Jaundice (yellow skin/eyes) Joint pain (chronic)- PZA **Light colored stools **Loss of appetite **Malaise/fatigue **Nausea/vomiting **Numbness/tingling **Skin rashes/itching **Sores on lips or inside mouth **Unusual bleeding (nose, gums, stool, urine, etc. or easy bruising)-RIF ...
[DOCX File]eval form - RehabEdge
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Skin: Rashes, lesions, wounds, ulcers, tumors, masses, bruises/ecchymoses, change in moles, itching, acne, diaper rash, burns, temperature changes, hair growth/loss.
Headache, Numbness or tingling and Numbness or tingling: Comm…
Numbness/Tingling- Right . Numbness/Tingling- Left . Numbness/Tingling- Both . Unable To Speak. Decreased Consciousness . Unsteadiness/Severe . Dizziness . Double Vision . One-Sided Weakness Previous treatments: (please give name of provider, date, type of treatment and if it helped) Name of provider, date, type of treatment Primary care provider
[DOC File]TB-206 DOTLog 12 - Texas
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( Recent weight gain; how much____ ( Headaches ( Depression ( Recent weight loss: how much____ ( Dizziness ( Excessive worries ( Fatigue ( Fainting or loss of consciousness ( Difficulty falling asleep ( Weakness ( Numbness or tingling ( Difficulty staying asleep ( Fever ( Memory loss ( Difficulties with sexual arousal ( Night sweats
[DOCX File]CONFIDENTIAL PATIENT INFORMATION
https://info.5y1.org/headaches-with-numbness-and-tingling_1_571358.html
Palpitations / irregular heartbeats NEUROLOGICAL Numbness Tingling Seizures Headaches Dizziness Vertigo GASTROINTESTINAL Nausea Vomiting Constipation Acid reflux Diarrhea Abdominal pain SLEEP Loud Snoring Daytime Fatigue
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