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Free Medical Telephone Consultation Form - PDF Form Download

Medical Telephone Consultation Form Overall rating: ☆☆☆☆☆ 0 based on 0 reviews
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This is a Medical Telephone Consultation Form, which is used to record a Patient’s health information, when the doctor or nurse is performing a consultation over the phone. This form is a great way to keep a track of all the necessary medical information said over the span of the phone conversation.


What to fill in this Medical Telephone Consultation Form?

  • First and foremost you must enter the Date of this telephonic conversation.
  • Then you must entire the time.
  • Next you should enter the Patient’s name, also confirm if the caller is the patient themselves or someone else.
  • Then you must get an assessment of the Patient.
  • You must also get the caller to get the Patient’s Temperature.
  • Then you must enter the current Presenting problems that the patient is suffering from.
  • Then you must provide the caller with the Plan of action that they will need to follow in regards to the patient.
  • You must also mention of the patient has or is suffering from any allergies.

Last you must enter the date again in the last section of this Medical Telephone Consultation Form. You must also initial in the place provided for it. You must also enter your final diagnosis on the problem the patient is suffering from. You can download this document by clicking on the link below.
Medical Telephone Consultation Form

Sample Form

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