Outpatient Follow-Up Progress Note Template

Patient Name:
Date / Time:
Reason for Visit:

Subjective:
- Interval History:
- Medication Adherence:
- Patient Concerns:

Objective:
- Vitals:
- Physical Exam Highlights:
- Labs/Imaging Reviewed:

Assessment:
- Active Problems with Status:
- Response to Treatment:

Plan:
- Diagnostics Ordered:
- Medication Changes:
- Education/Instructions:
- Follow-up Timing:

Sign-off:
- Provider Signature  Credentials
- Date / Time