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It includes symptom checklists for general, endocrine/metabolic, hematologic, skin, eyes, ENT, oral, cardiovascular, pulmonary, breasts, gastrointestinal, musculoskeletal, neurologic, psychiatric, genitourinary, and OB/GYN, plus vitals and detailed head-to-toe examination prompts. It provides instructions for marking positives, documenting negatives, noting exam refusal or deferral reasons, recording assessment tools, and completing attending physician review and preventive care boxes.",{"@graph":63,"@context":118},[64,80,101],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":36,"@type":70,"position":76},"https://docshare.wps.com/template/forms/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/ms-exam-form-medical-screening-checklist/194456/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/ms-exam-form-medical-screening-checklist/194456.png","ImageObject",442,249,{"name":88,"@type":89},"Aria","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-10-07","2026-09-03",true,{"@type":98,"interactionType":99,"userInteractionCount":15},"InteractionCounter",{"@type":100},"ViewAction",{"@type":102,"mainEntity":103},"FAQPage",[104,110,114],{"name":105,"@type":106,"acceptedAnswer":107},"How should abnormalities and negatives be recorded on the form?","Question",{"text":108,"@type":109},"Line through negatives and circle positives, then describe the relevant findings. For incomplete exams, document why the exam was not done.","Answer",{"name":111,"@type":106,"acceptedAnswer":112},"What vitals and measurements are included?",{"text":113,"@type":109},"Temperature, heart rate, respiratory rate, blood pressure (supine and seated/standing), height, weight (lb/kg actual/estimated), pulse oximetry with oxygen percentage, and pain are listed for entry.",{"name":115,"@type":106,"acceptedAnswer":116},"What instructions apply when a required exam is not completed or is refused?",{"text":117,"@type":109},"If the exam is not done, document the reason. If the patient refuses, document that risks of not completing the exam were discussed with the patient.","https://schema.org",{"og:url":78,"og:type":120,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":122,"canonical":78},"index,follow",{"doc_id":124,"site_id":56},194456,1790004492,{"code":4,"msg":5,"data":127},{"doc_id":124,"user_id":128,"nickname":88,"user_avatar":129,"doc_module":9,"category_id":35,"category_name":36,"doc_title":59,"doc_description":61,"doc_content":130,"file_id":131,"file_url":132,"file_type":133,"file_size":134,"view_count":15,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":135,"language":136,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":137,"faqs":138,"seo_title":139,"seo_description":61,"update_tm":140,"read_time":73},2336464648322,"https://ap-avatar.wpscdn.com/avatar/2200025388227c56fec?_k=1778556882303663488","|  |\n| --- |\n|  |\n|  |\n\n\n| 1. GENERAL c No abnormals\u003Cbr>Fever Chills Adenopathy\u003Cbr>Anorexia Diaphoresis Lightheadedness\u003Cbr>Weight gain Weight loss Edema\u003Cbr>2. ENDOCRINE/METABOLIC c No abnormals\u003Cbr>Throid disorder Temp intolerance Goiter\u003Cbr>Radiation exposure Diabetes Lipid disorder\u003Cbr>3. HEMATOLOGIC c No abnormals\u003Cbr>Anemia Sickle cell Leukemia\u003Cbr>Transfusions Bruising Bleeding | Line through negatives; circle positives and describe\u003Cbr> |\n| --- | --- |\n\n\n| 4. SKIN c No abnormals\u003Cbr>Pruritus Rash Mole changes\u003Cbr>Skin cancer Tattoos Hair or nail changes\u003Cbr>5. EYES c No abnormals\u003Cbr>Corrective lenses Cataracts Glaucoma\u003Cbr>Photophobia Visual change Laser surgery\u003Cbr>6. ENT c No abnormals\u003Cbr>Infections Hearing loss Vertigo\u003Cbr>Tinnitus Epistaxis Hoarseness\u003Cbr>7. ORAL c No abnormals\u003Cbr>Condition of teeth Dentures Lesions\u003Cbr>Pain Infections Dysgeusia\u003Cbr>8. CARDIOVASCULAR c No abnormals\u003Cbr>Chest pain Chest pressure Palpitations\u003Cbr>Syncope Orthopnea PND\u003Cbr>MI Hypertension Cardiac cath\u003Cbr>Murmur Rheumatic fever Dysrhythmia\u003Cbr>Claudication Aneurysm Varicosities\u003Cbr>DVT/PE Thrombophlebitis Raynaud’s\u003Cbr>9. PULMONARY c No abnormals\u003Cbr>Dyspnea Cough Hemoptysis\u003Cbr>Asthma/COPD Wheezing Tuberculosis\u003Cbr>Positive PPD TB exposure\u003Cbr>10. BREASTS c No abnormals\u003Cbr>Mass Tenderness Discharge\u003Cbr>Asymmetry Gynecomastia Implants\u003Cbr>Mammograohy (include dates and provider\u003Cbr>11. GASTROINTESTINAL c No abnormals\u003Cbr>Dysphagia Odynophagia Heartburn\u003Cbr>Abdominal pain Nausea/vomiting Hematemesis Hematochezia Melena Diarrhea\u003Cbr>Constipation Ulcers Hepatitis\u003Cbr>Pancreatitis Gallstones Colitis\u003Cbr>Jaundice Hemorrhoids Hernia\u003Cbr>Fecal occult blood/endoscopy (include dates and results)\u003Cbr>12. MUSCULOSKELETAL c No abnormals\u003Cbr>Pain Arthritis Deformity\u003Cbr>Stiffness Swelling Injury\u003Cbr>13. NEUROLOGIC c No abnormals\u003Cbr>Paresthesia Paralysis/paresis Headache\u003Cbr>Head trauma Syncope CVA/TIA\u003Cbr>Seizures Tremor Weakness\u003Cbr>Gait abnormality Dysarthria\u003Cbr>14. PSYCHIATRIC c No abnormals\u003Cbr>Anxiety Depression Psychosis\u003Cbr>Memory loss Psych treatment\u003Cbr>15. GENITOURINARY c No abnormals\u003Cbr>Hematuria Dysuria Urgency\u003Cbr>Frequency Nocturia Incontinence\u003Cbr>Change in stream Infection Nephrolithiasis\u003Cbr>16. GENITOREPRODUCTIVE c No abnormals ALL Multiple partners STD’s\u003Cbr>MALE Impotence Pain Mass\u003Cbr>Testicular self exam Penile discharge FEMALE Abnormal bleeding Dyspareunia PMS\u003Cbr>Hormone use Contraception Infertility\u003Cbr>17. OB/GYN: complete below\u003Cbr>G  P   FDLMP\u003Cbr>Menarche   Menopause   |  |\n| --- | --- |\n\n| VITALS Temp   HR   /min RR   /min BP supine   BP seated/standing   Height   Weight   lb / kg (actual / est) Pulse ox   % on   Pain   |  |\n| --- | --- |\n| 1. GENERAL\u003Cbr>Status General appearance\u003Cbr>Skin color Acutely / chronically ill\u003Cbr>Orientation Level of consciousness\u003Cbr>2. EYES c No abnormals c Not done\u003Cbr>Pupils Conjunctiva\u003Cbr>Fundus Extraocular motion\u003Cbr>3. ENT c No abnormals c Not done\u003Cbr>Head Hearing\u003Cbr>EAC Tympanic membranes\u003Cbr>Nasel Mucosa Gums and teeth Pharynx Tongue\u003Cbr>4. NECK c No abnormals c Not done\u003Cbr>Mobility Trachea\u003Cbr>Thyroid Masses\u003Cbr>5. LUNGS c No abnormals c Not done\u003Cbr>Wheeze Rhonchi\u003Cbr>Rales Friction rub\u003Cbr>Dullness Abnormal breath sounds\u003Cbr>6. HEART c No abnormals c Not done\u003Cbr>Rate Rhythum\u003Cbr>Heart sounds Murmur\u003Cbr>Rub PMI\u003Cbr>7. VASCULAR c No abnormals c Not done\u003Cbr>Pulses Bruits\u003Cbr>Stasis Varicosities\u003Cbr>Edema Capillary refill\u003Cbr>8. ABDOMEN c No abnormals c Not done\u003Cbr>Bowel sounds Tenderness\u003Cbr>Distension Abnormal percussion\u003Cbr>9. RECTAL c No abnormals c Not done\u003Cbr>Sphincter tone Masses\u003Cbr>Hemorrhoids Gross/occult blood\u003Cbr>10. NEURO c No abnormals c Not done\u003Cbr>Cranial nerves Cerebellar function Meningismus Deep tendon reflexes\u003Cbr>Muscle strength Pathologic reflexes Sensation Fine motor\u003Cbr>11. LYMPH c No abnormals c Not done\u003Cbr>Cervical Occipital\u003Cbr>Supraclavicular Axillary Inguinal Epitrochlear\u003Cbr>12. SKIN c No abnormals c Not done\u003Cbr>Turgor Lesions\u003Cbr>13. BREASTS c No abnormals c Not done\u003Cbr>Skin changes Nipple inversion\u003Cbr>Mass Tenderness\u003Cbr>Asymmetry Dis","cbCaimQgTKSbYUe0","https://ap.wps.com/l/cbCaimQgTKSbYUe0","pdf",201915,6,"English","# System-based symptom review\n## General to Genitoreproductive/OB-GYN\n# Vitals and physical exam components\n## Head-to-toe exam sections and documentation rules\n# Preventive care and instructions\n## Dietary, safety, disease prevention, and spine assessment","[{\"question\":\"How should abnormalities and negatives be recorded on the form?\",\"answer\":\"Line through negatives and circle positives, then describe the relevant findings. For incomplete exams, document why the exam was not done.\"},{\"question\":\"What vitals and measurements are included?\",\"answer\":\"Temperature, heart rate, respiratory rate, blood pressure (supine and seated/standing), height, weight (lb/kg actual/estimated), pulse oximetry with oxygen percentage, and pain are listed for entry.\"},{\"question\":\"What instructions apply when a required exam is not completed or is refused?\",\"answer\":\"If the exam is not done, document the reason. If the patient refuses, document that risks of not completing the exam were discussed with the patient.\"}]","MS Exam Form - Medical Screening Checklist | PDF",1788439242]