TELEPHONE CONSULTATION FORMCODE: [Choose code] ☐DOCTOR ONLY | ☐NURSE DATE | TIME [date | time] Call category [Choose category] PATIENT [Patient Name] Caller [Caller Name] phone 1 [phone 1] phone 2 [phone 2] Temp [Temp] ☐Test results [date | time] ☐Progress [Seen] ASSESSMENTS [Assessments] PRESENTING PROBLEMS [Presenting problems] | INITIAL [Initial] PLAN [Plan] ALLERGIES [Allergies] PHARMACY [Pharmacy] | INITIAL [Initial] Date [date | time] ☐problem [Problem]
TELEPHONE CONSULTATION FORMCODE: [Choose code] ☐DOCTOR ONLY | ☐NURSE DATE | TIME [date | time] Call category [Choose category] PATIENT [Patient Name] Caller [Caller Name] phone 1 [phone 1] phone 2 [phone 2] Temp [Temp] ☐Test results [date | time] ☐Progress [Seen] ASSESSMENTS [Assessments] PRESENTING PROBLEMS [Presenting problems] | INITIAL [Initial] PLAN [Plan] ALLERGIES [Allergies] PHARMACY [Pharmacy] | INITIAL [Initial] Date [date | time] ☐problem [Problem]