Here are the Clinical Checksheets my staff and I have developed over the past several years.  Some have been revised muiltiple times and seem to work very well.  Others need more revisions to work better.  As you all know it is an on-going process.  Please use this material, and feel free to give me any feedback which may improve these forms.

          Also some of the forms are in Abobe reader, and thus look exactly like the form we use. Other however have not yet been converted by Abobe, so what you will see is not exactly how our checksheets look.  Many of the lines and spacing have been altered in the  transfer from  a WordPerfect document into Netscape. The tables for subjective and objective data specifically have lost their lateral lines.  You'll see what I mean when you look at the forms.  Hope this is helpful to all those in the process of developing clinical checksheets.

Mary Arthur CRNP MPA
Director, Student Health Services
Dickinson College
Carlisle, PA 17013

General
 

• Abd. Pain
• Ankle injury
  Asthma
• Cold / cough
• Back pain
• Dermatitis
• Eating Disorders
• Field Trip
• Headaches
• Physical Exam
• Positive PPD yearly screening
• Redeye / conj.
• UTI / GU
• Vaginitis

• Birth Control Questions
• Birth Control Visit Consent form
• Pill check visit
• ECP / Preg. Test
• Depo Provera