Free Healthcare Checklist Template
Healthcare Checklist
[YOUR COMPANY NAME]
Routine Medical Evaluation Checklist
Effective from January 1, 2050
Section 1: Patient Identification
|
Task |
Date |
Completed By |
Comments |
|---|---|---|---|
|
January 1, 2050 |
[YOUR NAME] |
Verify using ID/records. |
|
January 1, 2050 |
[YOUR NAME] |
Ensure all forms are signed. |
Section 2: Medical History Review
|
Task |
Date |
Completed By |
Comments |
|---|---|---|---|
|
January 1, 2050 |
[YOUR NAME] |
Focus on chronic issues. |
|
January 1, 2050 |
[YOUR NAME] |
Update EHR if needed. |
Section 3: Physical Assessment
|
Task |
Date |
Completed By |
Comments |
|---|---|---|---|
|
January 1, 2050 |
[YOUR NAME] |
Note any abnormalities. |
|
January 1, 2050 |
[YOUR NAME] |
Use the standard checklist. |
Section 4: Recommendations and Follow-Up
|
Task |
Date |
Completed By |
Comments |
|---|---|---|---|
|
January 2, 2050 |
[YOUR NAME] |
Include prescribed meds. |
|
January 2, 2050 |
[YOUR NAME] |
Notify via email. |
Contact Information
-
Company Name: [YOUR COMPANY NAME]
-
Address: [YOUR COMPANY ADDRESS]
-
Email: [YOUR COMPANY EMAIL]
-
Phone: [YOUR COMPANY NUMBER]
Ensure your team is equipped with comprehensive checklists for every medical procedure. Contact [YOUR COMPANY NAME] at [YOUR EMAIL] to learn more or customize your own checklist today!
