History & Physical (H&P), include current physical assessment
Recent progress notes from your specialist/cardiologist
ECHO report and video, if available
Chest CT report and imaging
CTA or MRA report and imaging, if available
Cardiac catheterization results and video, if available
Results of holter monitoring, if available
List of current medications
Recent labs (within past 6 months)
History & Physical, including current physical assessment
Consult notes from oncologist
All imaging reports (MRI, PET/CT, etc.)
Biopsy reports (if completed)
Operative reports
Recent lab results to include a complete metabolic panel
Reports for any chemotherapy/radiation
History and Physical
Recent progress notes from Orthopedic surgeon, if any
Imaging reports and imaging, if any
History & Physical
Recent progress notes from current OB MD
Ultrasound reports and imaging
Labs
Provide the following information:
How many weeks pregnant are you?
When was the first day of your last menstrual period?
When is your estimated due date?
Is this your first pregnancy?
If this is not your first pregnancy, please provide the following:
How many pregnancies?
How many live births?
Delivery method: Vaginal or Cesarean?
History & Physical
Recent progress notes from your oncologist or neurologist outlining your medical history, current physical assessment, current treatment and treatment plan
All imaging reports, and imaging such as MRI, CTs, etc. including pre and post operative imaging
Pathology reports, if any
Operative reports, if any
History & Physical
Recent progress notes from your oncologist to include your medical history, current physical and neurological assessment, and current treatment plan.
Progress or consult notes from your cardiologist
Imaging reports and images (i.e. MRI, CT, Ultrasound, PET, etc.)
Recent labs (within past 6 months, to include CBC, metabolic panel, liver and kidney functions)
Operative reports, if any
Pathology reports, if any
Discharge summaries from any inpatient admissions
History & Physical
Recent progress notes from your urologist or gynecologist outlining your medical history, current physical assessment and current treatment plan.
Imaging reports and images (i.e. MRI, CT, Ultrasound, PET, etc.)
Cystoscopy results, if any
Recent labs (within the past 6 months, to include CBC, metabolic panel, etc.)
