HumanisRx - Follow-Up Consultation

Template structure

This is the structure Notat follows when it writes the note from the visit — you never fill it in by hand.

MedCheckUp - Follow-Up Consultation

PATIENT INFORMATION
(hyphenated list)
- First Name: [First name]
- Last Name: [Last name]
- PID: [Patient ID]
- Date of Birth: [Date of birth]
- Age: [Age]
- Consultation Date: [Consultation date]
- Method: [Method of consultation]
- Interviewed: [Person interviewed]
- Reasons for Referral: [Reason(s) for referral]

FOLLOW-UP # [Follow-up number]

NOTES AND ASSESSMENT
[Description of follow up consultation, including relevant history items]

Changes 
(hyphenated list) (only include what has changed)
[New DTPs found, see Care Plan]
[Medication updates, see BPMH]
[No new DTP]
[No medication updates]

Pharmacist Name: [Pharmacist name]
Licensing Province: [Province]
License #: [License number]
Documentation Completion and Sent Date: [yyyy-mm-dd]
Consultation Duration: [Minutes]