Miscellaneous
Share
Tweet
Cite
Click to rate this SOAPnote
[Total: 0 Average: 0]
approximately 21 views in the last month.
AP/Chart Review
Title: [text name="variable_1" default="sample text"]
Work Group: [text name="variable_2" default="sample text"]
Start Date: [date name="variable_3" default="11/23/2021"]
___________________________________________________________
Immunizations:
MMR: [checkbox name="variable_1" value="vaccine x 2|hx of pos titer|not required|not provided"]
Varicella: [checkbox name="variable_2" value="vaccine x 2|hx of pos titer|not required|not provided"]
Hep B: [checkbox name="variable_3" value="vaccine x 3|hx of pos titer|not required|not provided|other"]
Tdap: [checkbox name="variable_4" value="UTD|last immunization >10 years|not provided"]
Flu: [checkbox name="variable_5" value="UTD|not provided|other"]

COVID: [checkbox name="variable_6" value="Moderna x 2|Pfizer x 2|J&J x 1|not provided|other"]
TB: [checkbox name="variable_7" value="Proof of neg IGRA w/i 90 doh|not provided|hx of pos TST|not required"]
___________________________________________________________
Arch Baseline Questionnaire:[checkbox name="variable_9" value="clear|working with large animals, Q-fever required|not required"]
Respiratory Baseline Questionnaire:[checkbox name="variable_10" value="clear|not clear|not required"]
___________________________________________________________
Recommended: [textarea name="variable_11" default="sample text"]
Needs: [textarea name="variable_18" default="sample text"]
OHS clearance:[checkbox name="variable_19" value="clear|pending"]
AP/Chart Review
Title:
Work Group:
Start Date:
___________________________________________________________
Immunizations:
MMR:
Varicella:
Hep B:
Tdap:
Flu:

COVID:
TB:
___________________________________________________________
Arch Baseline Questionnaire:
Respiratory Baseline Questionnaire:
___________________________________________________________
Recommended:
Needs:
OHS clearance:

Result - Copy and paste this output:
Questions/General site feedback

Send Feedback for this SOAPnote

This site uses Akismet to reduce spam. Learn how your comment data is processed.

More SOAPnotes by this Author: