Highland & Redlands Pediatric & Adult Medicine
WCC / AG / HEBA
Clinic Notes
- Adult Visit
- Ancillary Test Sheet
- Anticoagulant (Coumadin) Record Sheet
- Circumcision Packet
- Consents / Authorizations:
- Consult Note
- Diabetes Log
- Flowsheet, Patient Visit
- Information / Demographics Page (m2p2 version)
- Lead Questionnaire: English | Spanish
- New Pediatric History Sheet: Scanned | Spanish | m2p2 Version
- Nurse Visit
- Opioid Maintenance Contract
- Phone Calls / Prescription Refills Note
- Progress Notes:
NOTE: Office staff may only complete "Reason for Visit"
| Generic Note #1 | Comments BELOW the physical exam |
| Generic Note #2 | Comments RIGHT of physical exam |
| Asthma Note | Packet | With Patient Education and Action Plan |
| Diabetes Note | Packet | With Core Packet from Patient Education page |
| Physician Assistant Note | |
| Interim / Sick Note (Highland) | |
- Student Note
- TB Risk Assessment - Patient Form: English | Spanish
- Vaccines:
- Vaccine Administration Record Sheet
- UHC EHR VIS Consent Form (Revised 4/2020)
- Flu Vaccine Consent: English
- Live Attenuated Influenza Vaccine (LAIV) Consent
Redlands Community Hospital Imaging Order Form
Referral Tracking Log (Redlands)
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