The purpose of this Narrative History is to capture additional needed health information, as well as the timeline in a historical timeline fashion. We have found that having a global narrative history of our patients helps us to recognize any patterns or causes of illness that may normally be hidden.

The format of your Narrative History document should look as follows and always follow chronological order either by year of occurrence or age at time occurrence. We've given you an idea of what should go in each section so that you'll know what to include, as well a patient example to review.

To the best of your knowledge, please write this History document either in a separate file (preferable Microsoft Word document) OR on this document as a template. Please complete the Narrative History 2 business days in advance of your appointment.

Information to include:

A. Patient Name

B. Chief Complaint/Reason for Visit Details - Using the primary reasons for seeking care at CHH, which you filled out on Page 1 of these forms, provide us detail on the following: 1) brief history on these specific issue(s), such as when it/they developed, how it/they has evolved, 2) any associated symptoms, and3) whether or not anything has been done to try and address the issue

C. Childhood History - Detail the following regarding birth to puberty: 1) Were you born by natural vaginal delivery or c-section? Foreceps used? Complicated pregnancy and/or birth? Were you breastfed? Did you receive all the normal childhood vaccinations? 3) Did you have a happy childhood? Was it stressful in any way? 4) Any major illness/injuries during this time period? 5) Do you remember certain symptoms that you had during this time period (and possibly still do) and any related or important events?

D. Adolescence History - Detail the following regarding puberty-adulthood/age 18: 1) Did you enjoy school? Were you a good student? Socially active? 2) Any stressful events? Did you sustain any major injuries/major illnesses 4) Do you remember certain symptoms that you had during this time period (and possibly still do) and any related or important events?

E.Adulthood History - Detail the following from age 18 to present 1) Did you attend college? Any relevant history of job changes? Job stresses? 2) Any stressful events? Major life adjustments/changes? Such as pregnancies, marriages, etc. 3) Those symptoms and issues that started during adulthood when did they begin, what tests might have been performed to assess these, are they resolved or unresolved?

History can include any of the following:

• Physical
  • Vaccinations
  • Major injuries (e.g. head traumas, motor vehicle accidents, fractures, etc)
  • Major illnesses (e.g. mononucleosis, chonic strep throat, etc)
  • Medication Changes (including antibiotics, birth control pills, etc)
  • Dietary Changes (e.g. vegetarian, vegan, lacto-vegan)
  • Menstrual difficulties
  • Surgeries
  • Changes in energy levels (e.g. fatigue, hyperactivity)
• Emotional
  • Life traumas (e.g. divorce, death, abuse- mental/physical/sexual)
  • Stressors (moving, career changes, marriage, divorce, etc.)
  • Education (social interactions, difficulties)
  • Travel (e.g. exposure to infectious diseases or stressful sitatuons)
  • Difficulty in relationships (parents, spouses, friends, children, workplace)
• Toxic Exposures
  • Pesticides, environmental, chemical, recreational drug use
  • Dental interventions (e.g. mercury fillings)
  • Mold exposures (home or workplace or other)
  • General anesthesia

Example of a Narrative History

Chief Complaint/Reason for Visit Details

1. Breast health concerns - Noticed a lump in my left breast in November 2014 (Age 38 No pain is associated with the lump and I had a mammogram in December 2014 that was negative. But had a thermography done in January 2015 and it revealed a higher risk.

2.Low energy x5 years - I noticed a decrease in my energy levels about 5 years ago (Age 33 It seemed to start right after delivering my 2nd child. Pregnancy was complicated (was sick frequently, went into labor early Despite adding adrenal support via supplements, I am still low on energy. 

3. Brain fog/memory issues - Over the last 4 months, I've noticed a lapse in my being able to juggle remembering tasks, names, etc. within my work and personal life. We moved into a new home 6 months ago. I've tired drinking more water and cutting out gluten but this hasn't helped.

Childhood history

• Born by NSVD with no complications. Not sure but believe was breastfed for 6 months and that I received all normal childhood vaccinations
• Age 8 - fractured left arm but had no surgery or hospitalization b/c of this Age 10 - parents divorced, which caused some emotional turmoil in the house for about 1 year
• Age 13 - started puberty Enjoyed high school socially, but was not good academically Age 18 - appendicitis. Had appendix removed. Was hospitalized for 3 days, then on antibiotics for 3 weeks

• Age 25 - got married. Was happy for about 8 years. Husband and I currently divorced.
• Age 26 - started birth control. Took for 1.5 years
• Age 27 - career took off and I worked 10+ hour days for about 2 years
• Age 29 - first pregnancy. No complications, healthy baby
• Age 33 - had my 2nd child and also went through divorce. Very difficult year for me physically and emotionally. Was sick frequently throughout pregnancy, delivered early)
• Age 34 - extreme fatigue set in. Tried taking adrenal support but this was not effective.
• Age 35 saw an endocrinologist who said both adrenals and thyroid was "OK"
• Age 36 tore ligament in right knee running. Saw orthopedist and had surgery. Currently still doing physical therapy 1x weekly

Here is where you will write your own Narrative History:

Center for Health and Healing- 800 S Frederick Avenue Suite 212-Gaithersburg, MD 20877