Acute Knee Injury Encounter Form

An evidence-based encounter form for evaluating acute knee injury

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Acute Otitis Media Encounter Form

An evidence-based encounter form for evaluating acute otitis media

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Asthma Encounter Form

A documentation form to identify important elements of care that are recommended for asthma visits

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Asthma Management Flow Sheet

A form for tracking key asthma indicators over several visits

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Cognitive Impairment Visit Template

A template to guide physicians in determining a patient's level of cognitive impairment

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Diabetes Encounter Form

An encounter form for use in documenting diabetes-related visits and ensuring that key issues are not overlooked during the visit

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Diabetes Encounter Form (Group Visits)

An encounter form designed to enable physicians to complete much of their documentation prior to a diabetes group visit

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Diabetes Flow Sheet

A flow sheet for recording patients’ essential diabetes measures, such as A1c rates, over time

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Emergency Nursing Record

A form for recording the details of an office-based emergency

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Group Visit Encounter Form (Nursing Home)

An encounter form for documenting the history of present illness and physical exams at nursing-home group visits

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House Call Encounter Form (Medicare)

An encounter form that guides physicians through the necessary home assessment, encourages accurate coding and helps document the necessity of the home visit

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Hypertension Encounter Form

An evidence-based encounter form for evaluating hypertension

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Medicare Initial Preventive Physical Examination Encounter Form ("Welcome to Medicare Physical")

An encounter form to ensure all elements of the initial preventive physical exam ("Welcome to Medicare Physical") are completed

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Medicare Preventive Physical Exam Encounter Form

An encounter form that details the components required for the "Welcome to Medicare Physical," the initial annual wellness Visit, and the subsequent annual wellness visit

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Nursing Home Documentation Form

A one-page form that standardizes and simplifies clinician documentation of nursing home care

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Pertussis Encounter Form: Community Exposure

A form to use throughout the process of contacting and treating patients who might have been exposed to pertussis in the community

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Pulmonary Embolism Screening Encounter Form

An evidence-based encounter form for evaluating pulmonary embolism risk

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Skin Care Encounter Form

An encounter form for rapidly and accurately coding skin-related diagnoses and associated procedures

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Sore Throat Encounter Form

An evidence-based encounter form for evaluating sore throats

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Upper Respiratory Infection Encounter Form

An encounter form for patients with upper respiratory infection symptoms that includes a patient questionnaire section and a physician evaluation section

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Well-Male Exam Encounter Form

A well-male exam encounter form that includes a patient-completed history, an exam documentation template and evidence-based screening test recommendations for all age groups

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Well-Woman Exam Encounter Form (one-page)

A visit-specific encounter form that shifts the responsibility for collecting patients’ health information to the patient and gives physicians more time during the encounter for preventive counseling or patient education

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Well-Woman Exam Encounter Form (three-page)

A well-woman exam encounter form that includes a patient-completed history, an exam documentation template and evidence-based screening test recommendations for all age groups

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