Lipoma Physical Exam Documentation Form
Document key findings and next steps from a lipoma physical examination.
Patient Name
*
First Name
Last Name
Patient Age
*
Date of Exam
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Exam Site/Location
*
Size of Mass (cm)
*
Consistency of Mass
*
Please Select
Soft
Firm
Rubbery
Other
Mobility of Mass
*
Please Select
Freely mobile
Fixed
Partially mobile
Associated Symptoms
Clinician Observations
Assessment and Next Steps
Submit Exam Documentation
Should be Empty: