[Insert Note Title Here] Note Fields List the desired questions or headings and fields (selections) for the documentation note. A notes function is to structure data from an assessment or exam, for documentation of interventions or events, and can focus on anything. Some examples of Notes include: health history, SOAP, SBAR, pain assessment, clinical journaling, home evaluation, telephone triage, and many more. Notes typically include structured questions and fields for documentation. Fields can be any of the following types: Instructional text (gives the student information, without enabling an action or documentation) Text area (enabling the student to write in an answer, long or short) Check boxes (enabling the student to select more than one answer from a list, as applicable) Radio buttons (enabling the student to select one choice from a short list of two or three choices) Combo boxes (a drop-down selection, enabling the student to select one of three or more choices) In this documentation note submission template, please list all text you want included in the note and indicate the type of field from the list above, if applicable. An example documentation note submission excerpt is shown below. The following note is for example purposes only: Vital Statistics Allergies: text Weight (lb/kg): text Hight (in cm): text Temperature: F/C text Pulse: text Respirations: text Blood Pressure: text Pain scale: combo box: options List out 0 – 10 Comments: text Contraception
[Insert Note Title Here] Note Fields List the desired questions or headings and fields (selections) for the documentation note. A notes function is to structure data from an assessment or exam, for documentation of interventions or events, and can focus on anything. Some examples of Notes include: health history, SOAP, SBAR, pain assessment, clinical journaling, home evaluation, telephone triage, and many more. Notes typically include structured questions and fields for documentation. Fields can be any of the following types: Instructional text (gives the student information, without enabling an action or documentation) Text area (enabling the student to write in an answer, long or short) Check boxes (enabling the student to select more than one answer from a list, as applicable) Radio buttons (enabling the student to select one choice from a short list of two or three choices) Combo boxes (a drop-down selection, enabling the student to select one of three or more choices) In this documentation note submission template, please list all text you want included in the note and indicate the type of field from the list above, if applicable. An example documentation note submission excerpt is shown below. The following note is for example purposes only: Vital Statistics Allergies: text Weight (lb/kg): text Hight (in cm): text Temperature: F/C text Pulse: text Respirations: text Blood Pressure: text Pain scale: combo box: options List out 0 – 10 Comments: text Contraception
Go-Documentation-Note-Submission-Template-v4.docx