**Interviewer Script:** - "Do you have any known allergies?

"
- "In case of an emergency, is there someone we
**I. Materials Needed:** should notify? If yes, could you provide their contact
- "Before we begin, have you filled out the Health details?"
History form with your details?" 2. **Chief Complaint:**
- "Do you have any questions about the form or - "What brings you in to see us today? What
anything you'd like to clarify?" symptoms or concerns are you experiencing?"
3. **History of Present Illness:**
**II. Assessment:** - "Can you describe how your current symptoms
- "Are you comfortable with the environment here?" started and what they feel like?"
- "Is there anything you'd like me to adjust to ensure - "Where on your body do you feel these symptoms,
your privacy during our conversation?" and do they spread to other areas?"
- "Would you prefer if I maintain a certain distance from - "How long have you been experiencing these
you during our discussion?" symptoms, and have they changed in severity over
time?"
**III. Pre-Introductory Phase:** - "On a scale of 1 to 10, how would you rate the
- "Have you had a chance to review your current and severity of your symptoms?"
past medical records?" - "What makes your symptoms better or worse?"
- "Could you share with me any specific goals you have 4. **Past Health History:**
for our discussion today?" - "Have you had any significant illnesses or surgeries
- "Do you have any concerns about my approach or in the past?"
appearance that I should address?" - "Are you up to date with your vaccinations?"
- "Would you mind if I sanitize my hands before we - "Do you have any chronic medical conditions or
continue?" ongoing health concerns?"
- "Are you currently taking any medications, including
**IV. Introductory Phase:** over-the-counter drugs or supplements?"
- "Hello, [Patient's Name]. I'm [Your Name], and I'll be 5. **Family Health History:**
conducting your health assessment today. How are you - "Are there any medical conditions that run in your
feeling?" family?"
- "I'd like to discuss your health history to better - "Can you tell me about the health of your parents,
understand your needs. Is that alright with you?" siblings, and grandparents?"
- "Before we proceed, would you like to know what
topics we'll be covering today?" **VI. Evaluation/Closing Phase:**
- "I'll be taking notes during our conversation to ensure - "Based on what we've discussed, I'd like to
I capture all relevant information. Is that okay with summarize the key points. Is there anything you'd like
you?" to add or clarify?"
- "I want to assure you that all information shared here - "Together, we can formulate a plan to address your
is confidential. Your privacy is important to me." health concerns. What are your thoughts on the next
steps?"
**V. Working Phase:** - "I want to ensure we're on the same page regarding
your health goals. Could you confirm if these align with
1. **Demographic Data:** your expectations?"
- "Could you please provide me with your name, - "Before we conclude, is there anything else you'd like
address, and contact number?" to discuss or any questions you have for me?"
- "What is your gender and age?"
- "Do you have any specific religious or cultural **VII. Documentation:**
preferences we should be aware of?" - "I'll be documenting our conversation to help with
- "Are you currently employed or attending school?" further analysis and planning. Is there anything specific
- "Are you married or single?" you'd like me to note?"
**Interviewer Script:** 2. **Chief Complaint:**
- "Did you obtain the reason for seeking health care
**I. Materials Needed:** or the chief complaint?"
- "Have you prepared the Health History form for data 3. **History of Present Illness:**
collection?" - "Did you obtain the history of present illness using
- "Are your materials for note-taking ready?" COLDSPA or PQRST?"
4. **Past Health History:**
**II. Assessment:** - "Did you obtain the patient's past health history?"
- "Have you assessed the safety of the environment?" 5. **Family Health History:**
- "Have you ensured the privacy of the environment?" - "Did you present the genogram and obtain family
- "Have you maintained a proper personal distance health history?"
from the patient?" 6. **Patient Story and Therapeutic Techniques:**
- "Did you invite the patient's story, observe cues, and
**III. Pre-Introductory Phase:** use critical thinking?"
- "Have you reviewed the patient's current and previous - "Did you utilize therapeutic techniques throughout
medical records, if available?" the working phase?"
- "Have you set the interview goals?"
- "Are you prepared in terms of your clinical behavior **VI. Evaluation/Closing Phase:**
and appearances?" - "Did you summarize the information obtained during
- "Have you performed hand hygiene and worn PPE as the interview to the client?"
appropriate?" - "Did you identify and discuss possible plans to
resolve the issues with the client?"
**IV. Introductory Phase:** - "Did you validate the problems and goals with the
- "Did you greet the patient and introduce yourself?" client?"
- "Have you explained the purpose of the interview?" - "Did you ask if the client has any further concerns or
- "Did you discuss the types of questions that will be questions?"
asked?"
- "Have you explained the reason for taking notes?" **VII. Documentation:**
- "Did you assure the client of the confidentiality of the - "Have you gathered all necessary findings from the
information gathered?" interview and health history form for analysis and
formulation of the nursing care plan?"
**V. Working Phase:**
1. **Demographic Data:**
- "Did you elicit the necessary demographic data?"