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