5 minutes to complete
To be eligible to complete the EMR downtime patient details form, a person must have knowledge and access to the patient's relevant medical information, be authorized to update and enter data into the form, and have training on the proper procedures for completing the form accurately.
Patient's full name
Patient's date of birth
Patient's gender
Patient's contact number
Patient's email address
Reason for Visit
Patient's emergency contact number
Patient's Medical record no.
Does the patient have any known allergies?
Does the patient have any pre-existing medical conditions?
Medications Added/Changed
Medications deleted
Recorded Medical staff name
Signature of the medical staff