Using the SOAP format, the evaluation and management (E/M) history that the physician takes is:

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The E/M history that a physician takes consists of subjective information provided by the patient. This includes the patient's chief complaint, medical history, family history, and social history. This information is considered subjective because it is based on the patient's perception and recollection of their health and medical history. The objective information is gathered during the physical examination and any diagnostic tests, while the assessment and plan are based on the physician's interpretation of all the information gathered.

Using the SOAP Format, the Evaluation and Management (E/M) History