Weight Loss EMR Chart Note Template for Patients
Create a weight loss plan appropriate to log as a chart note in an EMR as well as share with the patient.
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Weight Loss Plan
This snippet allows you to quickly generate a weight loss plan for a patient. It uses the formtext command, the formtoggle command, and the formmenu command.
Weight Loss Plan
Weight: {formtext: name=Current Weight} ({time: M/D/YY})
{formtoggle: name=Weight change; default=yes}Weight loss since the last visit: - {formtext: name=weight loss since last visit} lbs. in {formmenu: 2 weeks; default=1 month; 6 weeks; 2 months; name=weeks}
Total Weight loss since the medical weight loss program started: - {formtext: default=; name=total weight loss} lbs.{endformtoggle}
Initial Weight: {formtext: name=Initial Weight} lbs.
Goal weight: {formtext: name=Goal Weight} lbs.
{formmenu: default=- Continue; - Start; - Increase to; - Decrease to} {formmenu: default=Mounjaro (tirzepatide) 2.5 mg SQ weekly; Mounjaro (tirzepatide) 5 mg SQ weekly; Mounjaro (tirzepatide) 7.5 mg SQ weekly; Mounjaro (tirzepatide) 10 mg SQ weekly; Mounjaro (tirzepatide) 12.5 mg SQ weekly; Mounjaro (tirzepatide) 15 mg SQ weekly; Ozempic (semaglutide) 0.25 mg SQ weekly; Ozempic (semaglutide) 0.5 mg SQ weekly; Ozempic (semaglutide) 1 mg SQ weekly; Ozempic (semaglutide) 2 mg SQ weekly; Wegovy (semaglutide) 0.25 mg SQ weekly; Wegovy (semaglutide) 0.5 mg SQ weekly; Wegovy (semaglutide) 1 mg SQ weekly; Wegovy (semaglutide) 1.7 mg SQ weekly; Wegovy (semaglutide) 2.4 mg SQ weekly; Saxenda (liraglutide) 0.6 mg SQ QD; Saxenda (liraglutide) 1.2 mg SQ QD; Saxenda (liraglutide) 1.8 mg SQ QD; Saxenda (liraglutide) 2.4 mg SQ QD; Saxenda (liraglutide) 3.0 mg SQ QD; Victoza (liraglutide) 0.6 mg SQ QD; Victoza (liraglutide) 1.2 mg SQ QD; Victoza (liraglutide) 1.8 mg SQ QD; Contrave 8/90 mg 1 tab QAM x 1 week, then 1 tab BID x 1 week, then 2 tabs QAM and 1 tab QPM x 1 week, then 2 tabs BID thereafter; Contrave 8/90 mg 2 tabs PO BID; Trulicity 0.75 mg SQ weekly; Trulicity 1.5 mg SQ weekly; Trulicity 3 mg SQ weekly; Trulicity 4.5 mg SQ weekly; cols =25}
{formmenu: * * Rx x 2 months given * *\ ; * * Rx x 3 months given * *\ ; - Healthy lifestyle discussed, including eating and activity changes, sleep, and stress management.; default=- Patient doing very well and encouraged to continue with current dietary and lifestyle changes; - Educated patient on a carbohydrate modified diet; - Educated patient on intermitent fasting strategies; - Educated patient on benefits of incorporating a regular physical activity/exercise regimen to weekly routine; - Labs were reviewed with the patient today; - Patient needs to send labs to info@plushcare.com; - Labs were re-ordered and patient was instructed to get these done ASAP; - Referred patient to a Health Coach; - Transition to weight maintenance phase by cutting back on dosing/increasing interval between injections; - Start to plan towards transitioning from weight loss phase to weight maintenance phase\ ; - Plan is to provide for support at this weight range and to establish a new level of weight stability as we slowly wean patient off medication altogether; ; cols =45; multiple=yes; formatter=(items) -> join(items, "\n")}
Follow-up in {formmenu: default=1 month; 2 months; 3 months} or sooner as discussed.
The patient verbalized a clear understanding of my instructions and was agreeable to the plan.
{formtoggle: name=Weight change; default=yes}Weight loss since the last visit: - {formtext: name=weight loss since last visit} lbs. in {formmenu: 2 weeks; default=1 month; 6 weeks; 2 months; name=weeks}
Total Weight loss since the medical weight loss program started: - {formtext: default=; name=total weight loss} lbs.{endformtoggle}
Initial Weight: {formtext: name=Initial Weight} lbs.
Goal weight: {formtext: name=Goal Weight} lbs.
{formmenu: default=- Continue; - Start; - Increase to; - Decrease to} {formmenu: default=Mounjaro (tirzepatide) 2.5 mg SQ weekly; Mounjaro (tirzepatide) 5 mg SQ weekly; Mounjaro (tirzepatide) 7.5 mg SQ weekly; Mounjaro (tirzepatide) 10 mg SQ weekly; Mounjaro (tirzepatide) 12.5 mg SQ weekly; Mounjaro (tirzepatide) 15 mg SQ weekly; Ozempic (semaglutide) 0.25 mg SQ weekly; Ozempic (semaglutide) 0.5 mg SQ weekly; Ozempic (semaglutide) 1 mg SQ weekly; Ozempic (semaglutide) 2 mg SQ weekly; Wegovy (semaglutide) 0.25 mg SQ weekly; Wegovy (semaglutide) 0.5 mg SQ weekly; Wegovy (semaglutide) 1 mg SQ weekly; Wegovy (semaglutide) 1.7 mg SQ weekly; Wegovy (semaglutide) 2.4 mg SQ weekly; Saxenda (liraglutide) 0.6 mg SQ QD; Saxenda (liraglutide) 1.2 mg SQ QD; Saxenda (liraglutide) 1.8 mg SQ QD; Saxenda (liraglutide) 2.4 mg SQ QD; Saxenda (liraglutide) 3.0 mg SQ QD; Victoza (liraglutide) 0.6 mg SQ QD; Victoza (liraglutide) 1.2 mg SQ QD; Victoza (liraglutide) 1.8 mg SQ QD; Contrave 8/90 mg 1 tab QAM x 1 week, then 1 tab BID x 1 week, then 2 tabs QAM and 1 tab QPM x 1 week, then 2 tabs BID thereafter; Contrave 8/90 mg 2 tabs PO BID; Trulicity 0.75 mg SQ weekly; Trulicity 1.5 mg SQ weekly; Trulicity 3 mg SQ weekly; Trulicity 4.5 mg SQ weekly; cols =25}
{formmenu: * * Rx x 2 months given * *\ ; * * Rx x 3 months given * *\ ; - Healthy lifestyle discussed, including eating and activity changes, sleep, and stress management.; default=- Patient doing very well and encouraged to continue with current dietary and lifestyle changes; - Educated patient on a carbohydrate modified diet; - Educated patient on intermitent fasting strategies; - Educated patient on benefits of incorporating a regular physical activity/exercise regimen to weekly routine; - Labs were reviewed with the patient today; - Patient needs to send labs to info@plushcare.com; - Labs were re-ordered and patient was instructed to get these done ASAP; - Referred patient to a Health Coach; - Transition to weight maintenance phase by cutting back on dosing/increasing interval between injections; - Start to plan towards transitioning from weight loss phase to weight maintenance phase\ ; - Plan is to provide for support at this weight range and to establish a new level of weight stability as we slowly wean patient off medication altogether; ; cols =45; multiple=yes; formatter=(items) -> join(items, "\n")}
Follow-up in {formmenu: default=1 month; 2 months; 3 months} or sooner as discussed.
The patient verbalized a clear understanding of my instructions and was agreeable to the plan.
_
