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