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Family Medicine

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Family Medicine SOAP

Template structure

This is the structure Notat follows when it writes the note from the visit — you never fill it in by hand.

Subjective:
(hyphenated list)
- [Chief complaint or reason for visit]
- [Relevant relevant history and associated information in chronological order]

Objective:
(hyphenated list)
- [Vital signs with units in one line] (e.g., HR: #, BP: #, T: #, RR: #, O2 sats: #%)
- [Physical exam findings and/or mental status exam findings] (Format as "System: Exam findings", one system per line. Specify anatomical location if relevant)
- [Investigation results with units] (Only include completed investigations, otherwise leave blank. All planned or ordered investigations should be included under Plan)

Assessment:
(hyphenated list)
- [Diagnosis and reasoning] (Use medical terminology if appropriate. Do not re-state all past medical history unless relevant)
- [Differential diagnosis if mentioned]

Plan:
(hyphenated list)
- [Investigations planned or ordered]
- [Treatment plan]
- [Counselling discussion]
- [Referrals sent]
- [Follow up plan]
- [Return precautions]

Shared by

SL

Dr. Sofie Lindqvist

Clinic Director, Sweden

How it works in Notat

Add this template to your library, record the visit as usual, and Notat drafts the note in this exact structure from the extracted clinical facts. You review, edit, and sign.

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