Surgery/Procedure: Surgeon: Was Anesthesiologist Present?
Y/ N (If no, state reason)
Informed Consent Signed Prior to Procedure? By Whom (patient or representative)? Discharge Instructions: Discharge Status: Review Physician’s Discharge Instructions. Are there any instructions not linked to diagnoses?
Copyright ©2020 by the American Health Information Management Association. All rights reserved.
Powered by FlippingBook