Social History

• Include occupation, highest level of education, home situation and significant others

• Quantify any tobacco, alcohol or other drug use

• Include relevant sexual history

• Note any safety concerns by the patient (domestic violence, neglect)

• Note presence of advance directives (e.g., living will and/or health care power of attorney)

• Assess the patient’s functional status – ability to complete the activities of daily living

• Consider documentation of any important life experience such as military service, religious

• affiliation and spiritual beliefs