Patient presents with signs and symptoms consistent with precocious puberty.  Onset of secondary sexual characteristics was noted at age [Patient Age], which is below the normal age range for puberty.  Specific findings include [List specific findings, e.g., breast development Tanner stage [Stage], pubic hair development Tanner stage [Stage], axillary hair development, menarche, testicular enlargement, advanced bone age].  The patient's medical history is significant for [Relevant medical history, e.g., family history of precocious puberty, central nervous system disorders, adrenal disorders, exposure to exogenous hormones].  Medications include [List current medications].  Physical examination reveals [Relevant physical exam findings, e.g., height and weight percentiles, body mass index, specific findings related to pubertal development].  Differential diagnosis includes central precocious puberty, peripheral precocious puberty, premature thelarche, premature adrenarche, and variations of normal development.  Initial laboratory evaluation will include [List planned labs, e.g., LH, FSH, estradiol, testosterone, bone age radiograph, GnRH stimulation test].  Further investigation may involve [List potential further investigations, e.g., pelvic ultrasound, adrenal ultrasound, brain MRI].  The plan is to determine the underlying cause of the precocious puberty and initiate appropriate management, which may include GnRH agonist therapy if indicated.  Patient and family were counseled regarding the diagnosis, potential treatment options, and the importance of follow-up care.  ICD-10 code V90.1 (Precocious puberty) is assigned.  Return appointment scheduled in [Timeframe] to review laboratory results and discuss further management.