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    GP Note

    Created by

    Kate Robinson

    Specialty

    General Practitioner

    Last edited

    10/20/2026

    Uses

    0 times

    Tags

    General Practitioner

    About this template

    A structured template for documenting general practice consultations, including presenting problems, examination findings, assessments, and plans. It supports concise recording of multiple issues while retaining relevant clinical history and management details.

    Preview template

    ?Cough and Fever- 3/7 productive cough with green sputum, tactile fevers, coryza, sore throat

    • nil haemoptysis, nil SOB, nil chest pain
    • PHx: mild asthma (uses salbutamol (Ventolin®) 100 mcg INH PRN), ex-smoker
    • SHx: lives with partner, works in office

    Repeat medications

    • requests repeat of regular antihypertensives
    • compliant with meds, nil side effects, home BP readings averaging 125/75

    ?R knee pain

    • mentioned at end of consult: 2/52 history of R medial knee pain, mild swelling, stiffness in morning, nil locking or giving way
    • onset after long hike, nil acute trauma

    oe \bp 128/78 \wt 84

    • Temp 37.6 °C, SpO2 98 %, HR 82 bpm
    • Looks well, nil increased WOB
    • Ears: R) normal canal, TM nad, L) normal canal, TM nad
    • Pharynx mildly erythematous, nil exudate, nil cervical lymphadenopathy
    • HSD nil murmurs - regular
    • Chest clear and equal - no creps or wheezes
    • Abdo SNT, no signs peritonism. Nil organomegaly. Nil masses. Nil flank tenderness.
    • R knee: mild joint effusion, tender medial joint line, ROM full, McMurray's negative, ligaments stable

    Imp: Cough and Fever, viral URTI, acute bronchitis

    • Repeat medications, essential hypertension
    • R knee pain, osteoarthritis, medial meniscal tear

    Plan

    • Weight-bearing X-ray R knee, routine bloods for annual hypertension screen
    • Regular medicines were repeated; paracetamol (Panadol®) 1,000 mg PO QID PRN and ibuprofen (Nurofen®) 400 mg PO TID PRN for fever and knee pain; symptomatic URTI management discussed, return if worsening SOB or persistent fever > 5/7
    • Referral to physiotherapy for R knee strengtheningUnderstood. I will adhere strictly to the template structure and formatting constraints.

    How to use this template

    This template can be used to assist with various tasks in the medical field. You can use it to generate notes, manage patient information, or assist with diagnosis and the Assessment and Plan. To use this template, simply click the “Use Template” button above. If you have any questions or need assistance, feel free to reach out to the support team or refer to the description and example output provided above.

    Tags

    General Practitioner