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In this tutorial, you will learn to use restatement, reflection, and clarification to gather and accurately document patient information. Begin by greeting the patient pleasantly and introducing yourself, explaining your role. For instance, say, "Hi, Mr. Dixon, I'm Laura and I'm updating your medical record today." To ensure confidentiality, choose a private setting for the interview and explain the importance of the information being collected. Use therapeutic communication techniques to complete the history form, documenting the patient's full name, address, marital status, gender, age, date of birth, phone numbers, insurance information, and employer details. If any information is previously recorded, verify its accuracy.
