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    CLINIC VISIT FRONT SIDE-Edge

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    hanniemaelimon
    This document is a record from the Edgewood Jr/Sr High School Clinic. It includes fields to log a student's name, grade, time of arrival and departure from the clinic, reason for visit including complaints such as injury, illness, or need for feminine hygiene products, location of any pain/injury, when symptoms started, whether parents are aware and if the student took any medicine or food/fluids before arriving, and temperature.

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    CLINIC VISIT FRONT SIDE-Edge

    Uploaded by

    hanniemaelimon
    18 views1 page
    This document is a record from the Edgewood Jr/Sr High School Clinic. It includes fields to log a student's name, grade, time of arrival and departure from the clinic, reason for visit including complaints such as injury, illness, or need for feminine hygiene products, location of any pain/injury, when symptoms started, whether parents are aware and if the student took any medicine or food/fluids before arriving, and temperature.

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    CLINIC_VISIT_FRONT_SIDE-Edge

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    This document is a record from the Edgewood Jr/Sr High School Clinic. It includes fields to log a student's name, grade, time of arrival and departure from the clinic, reason for visit including complaints such as injury, illness, or need for feminine hygiene products, location of any pain/injury, when symptoms started, whether parents are aware and if the student took any medicine or food/fluids before arriving, and temperature.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as doc, pdf, or txt
    18 views1 page

    CLINIC VISIT FRONT SIDE-Edge

    Uploaded by

    hanniemaelimon
    This document is a record from the Edgewood Jr/Sr High School Clinic. It includes fields to log a student's name, grade, time of arrival and departure from the clinic, reason for visit including complaints such as injury, illness, or need for feminine hygiene products, location of any pain/injury, when symptoms started, whether parents are aware and if the student took any medicine or food/fluids before arriving, and temperature.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as doc, pdf, or txt
    of 1

    Edgewood Jr/Sr High School Clinic Visit & Record of Nursing Treatment

    Date:________________ Name:__________________________________________________ Grade:__________

    Time Arrived in Clinic:____________ Time Left Clinic:____________

    REASON FOR VISIT / COMPLAINT:


    ___Abrasion/minor cut* ___Earache* ___Sore Throat
    ___Blister* ___Eye * ___Splinter* ___Need for Feminine Hygiene Product
    ___Bloody nose ___Fever ___Stomach Pain / Cramps / Nausea
    ___Breathing Problem ___Headache ___Tooth or Mouth Pain
    ___Bump/Swelling* ___Head Lice ___Vomiting: witnessed / not witnessed (circle one)
    ___Congestion/Cold ___INJURY* ___Cough ___Insect Bite*
    ___Dizzy/light headed/Weak/Tired ___Rash* ___ OTHER REASON:_________________________

    ___(*) LOCATION(S) OF PAIN/INJURY/ILLNESS :____________________________________________________________


    Symptoms started ____________ Yes/No parents aware of symptoms Yes/No PO intake of food/fluids
    Yes/No medicine at home prior to coming to school
    Temperature PO/Temporal/Axillary

    Edgewood Jr/Sr High School Clinic Visit & Record of Nursing Treatment
    Date:________________ Name:__________________________________________________ Grade:__________

    Time Arrived in Clinic:____________ Time Left Clinic:____________

    REASON FOR VISIT / COMPLAINT:


    ___Abrasion/minor cut* ___Earache* ___Sore Throat
    ___Blister* ___Eye * ___Splinter* ___Need for Feminine Hygiene Product
    ___Bloody nose ___Fever ___Stomach Pain / Cramps / Nausea
    ___Breathing Problem ___Headache ___Tooth or Mouth Pain
    ___Bump/Swelling* ___Head Lice ___Vomiting: witnessed / not witnessed (circle one)
    ___Congestion/Cold ___INJURY*
    ___Cough ___Insect Bite*
    ___Dizzy/light headed/Weak/Tired ___Rash* ___ OTHER REASON:____________________________

    ___(*) LOCATION(S) OF PAIN/INJURY/ILLNESS :____________________________________________________________


    Symptoms started _________________ Yes/No parents aware of symptoms Yes/No PO intake of food/fluids
    Yes/No medicine at home prior to coming to school
    Temperature PO/Temporal/Axillary

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