-- Travel: *** domestic, international, where exactly, how long, what did you do when you were there, food and water consumed; take immunizations/prophylactics before going?
-- Work exposure: *** homeless, military, prison populations
-- Drug Use: *** alcohol, tobacco, recreational (name, freq, last use), IV drugs
-- Sexual Hx: *** number and genders of partners over last 12 months, practices - genital, anal, oral, protection, past hx of / testing for STI and if they were treated, prevention of preg
-- Hobbies: *** garden, water, outdoors, etc
-- Dietary Hx: *** raw, undercooked meat, unpasteurized milk, etc
-- Animal Exposure: *** pets, zoos, wild, other
PDF coming soon!