SAMPLE

Question 1

S

Answer 1

Signs and Symptoms. A sign is something you see with your own eyes like being pale and sweaty. A symptom is something the patient feels and tells you about such as dizziness or chest pain.

Question 2

A

Answer 2

Allergies. Ask if the patient has ever had any allergic reactions to any medications including environmental allergies like food and insect things.

Question 3

M

Answer 3

Medications. Ask if patient takes any medications. Ask about over-the-counter medicines, vitamins, supplements, herbals or home remedies.

Question 4

P

Answer 4

Past Medical History. Ask about relevant medical history.

Question 5

L

Answer 5

Last Oral Intake. Ask about the patient’s last intake of food or drink. It’s also important to know if the patient smokes, what they smoke, and when the last time they smoked was.

Question 6

E

Answer 6

Events Leading Up to Illness or Injury. What we’re doing when this happened?