Allergies noted Staff notification if needed No abbreviations Parent Name documented Procedure details recorded Correct template as appropriate Follow up plan documented Athletic clearance if appropriate Clear discharge instructions IHP referenced RAD Complete VS recheck recorded as appropriate Health history referenced Billable duration 5 minutes + Treatment authorization verified Parent contact attempt and times Confidentiality maintained Return to class/dismissed early Documented Out time Interventions Provided Assessment findings listed and appropriate Medication administration details VS recorded as appropriate Clinic visit outcome provided Chief complaint recorded Student's response to treatment Parent contact information documented In Time Student's verbal description noted Parent notification documented Allergies noted Staff notification if needed No abbreviations Parent Name documented Procedure details recorded Correct template as appropriate Follow up plan documented Athletic clearance if appropriate Clear discharge instructions IHP referenced RAD Complete VS recheck recorded as appropriate Health history referenced Billable duration 5 minutes + Treatment authorization verified Parent contact attempt and times Confidentiality maintained Return to class/dismissed early Documented Out time Interventions Provided Assessment findings listed and appropriate Medication administration details VS recorded as appropriate Clinic visit outcome provided Chief complaint recorded Student's response to treatment Parent contact information documented In Time Student's verbal description noted Parent notification documented
(Print)
Allergies noted
Staff notification if needed
No abbreviations
Parent Name documented
Procedure details recorded
Correct template as appropriate
Follow up plan documented
Athletic clearance if appropriate
Clear discharge instructions
IHP referenced
RAD Complete
VS recheck recorded as appropriate
Health history referenced
Billable duration 5 minutes +
Treatment authorization verified
Parent contact attempt and times
Confidentiality maintained
Return to class/dismissed early Documented
Out time
Interventions Provided
Assessment findings listed and appropriate
Medication administration details
VS recorded as appropriate
Clinic visit outcome provided
Chief complaint recorded
Student's response to treatment
Parent contact information documented
In Time
Student's verbal description noted
Parent notification documented
