Patient Record Form

 

 

Question 1-10:

Complete the form below

Write NO MORE THAN THREE WORDS AND/OR A NUMBER for each answer

Temporary Patient Record Form

Name: Example

Peter Smith

Street address: 1. ………………………………
Suburb: 2. ………………………………
Phone number: 3. ………………………………

Details of injury

Sport: Tennis
Type of injury: Sprained 4. ………………………………
Date of injury: 5. ………………………………

Previous treatment and current problems

The patient’s own doctor advised treatment with 6. ……………………………….
The patient is unable to 7. ……………………………… and he is experiencing pain in his 8. ……………………………… at night, which is affecting his sleep.

Advice given

Stop using the 9. ………………………………
Do regular 10. ……………………………… at home

 

 


Keys

Here are the answers for Section 1:

      1. 95 Cross Street
      2. Walkley
      3. 4689 5324
      4. knee
      5. 18th June
      6. (an) ice pack
      7. go upstairs
      8. back
      9. stick
      10. exercises

 

 

Transcript

You will hear a man talking first to a receptionist and then to a doctor at a health centre.

Good morning, how can I help you?
Uh, yes. I’m a visitor to this area. I had a sporting accident a little while ago, and I’m still in some pain, and I wondered if I could see a doctor here.
Certainly, sir, we can take you on as a temporary patient. I’ll just take down some personal details. Can I start with your name?
Yes, it’s Peter. Peter Smith.
Right, Peter. And where are you staying here?
At 95 Cross Street.
And the suburb?
Walkley. That’s W-A-L-K-L-E-Y.
Mm-hmm. And can I have a contact phone number?
Uh, it’s 4 6 8 9 5 3 2 4.
Thanks. Okay, if you just wait down there, the doctor will see you in a minute.

Now, what can I do for you? It’s Peter Smith, isn’t it?
Yes, I had a sporting accident and was treated by a doctor at home, but I’m still in pain.
Right, I just need to ask you a few questions first of all.
Fine.
Now, what sport were you doing?
I was playing tennis.
I see. And what was the nature of your injury? Did you hurt your elbow or wrist?
Uh, no. I had a sprained knee. That was the original problem.
Right, and when did this happen?
Uh, it was three weeks ago now, so that was June 18th.
Fine. And you say you had medical treatment?
Yes, the doctor said I didn’t need an x-ray or anything, and he just told me to use an ice pack.
An ice pack. Fine.
Yes, and I’ve been using a walking stick to help me get around.

Right, now what problems are you experiencing at the moment? Are you having any problems walking?
Well, I can walk okay, but I still can’t go upstairs, so I’ve been sleeping downstairs.
Now, you say your knee still hurts?
Well, no. Actually, it’s recovering nicely. It’s my back that’s hurting me now.
It really aches at night, and I can hardly sleep.
Well, there’s a few different things I can suggest for that.
Great.
First, you should put your stick away, as that’s probably the source of the problem. It’ll be making you unbalanced.
Oh, really? I wish I’d known.
After that I can prescribe you something to relax the muscles in your back.
Oh, sorry to be difficult, but I’ve had something like that in the past, and there were lots of side effects, and I had to stop taking it. Can you recommend anything else?
Well, yes, we do have a leaflet showing some exercises you can do to help yourself at home.
If you do them every day, they’ll soon be effective.
Great. I’ll do that.