Ficha de Avaliação

Nome: _______________________________________________________________________________
Idade: ________ Nascimento: _________________ Sexo: ____________________________________
Profissão: ____________________________________________________________________________

Anamnese
Motivo da Consulta: _____________________________________________________________________
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HDA: ________________________________________________________________________________
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HDP: ________________________________________________________________________________
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Medicações: __________________________________________________________________________
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Estado Geral
Emocional: ___________________________________________________________________________
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Cardiorrespiratório: _____________________________________________________________________
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Digestivo: _____________________________________________________________________________
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Intestinal: _____________________________________________________________________________
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Urinário: ______________________________________________________________________________
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Dermatológico: ________________________________________________________________________
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Neurológico: __________________________________________________________________________
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Exame Físico
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Avaliação Auricular

Inspeção (manchas, vascularização, escamações e alterações morfológicas)

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Palpação (alterações morfológicas, reação à dor, depressões, edemas e escamações)
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Conclusão
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