Moreno Valley Internal Medicine & Pediatric Clinic
Quick Links
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| Clinical Desktop |
Formulary: IEHP |
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Hemoglobin / Hematocrit Normals |
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| Term | 16.5 (13.5) | 51 (42) | 2 - 6 years | 12.5 (11.5) | 37 (34) | |
| 1 - 3 Days | 18.5 (14.5) | 56 (45) | 6 - 12 years | 13.5 (11.5 | 40 (35) | |
| 2 weeks | 16.6 (13.4) | 53 (41) | 12 - 18 years | |||
| 1 month | 13.9 (10.7) | 44 (33) | Male Female |
14.5 (13) 14.0 (12) |
40 (35) 43 (36) |
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| 2 months | 11.2 (9.4) | 35 (28) | Adults | |||
| 6 months | 12.6 (11.1) | 36 (31) | Male Female |
15.5 (13.5) 14.0 (12) |
47 (41) 47 (41) |
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| 6 mos - 2 yrs | 12.0 (10.5) | 36 (33) | ||||
| From Harriet Lane | ||||||
WCC / AG / HEBA
Clinic Notes
- Adult Visit
- Ancillary Test Sheet
- Anticoagulant (Coumadin) Record Sheet
- Arrived Clinic Numbers
- Circumcision Packet
- Consents / Authorizations:
- Consult Note
- Diabetes Log
- Diagnostic Summary Sheet
- Excuse Note
- Fax Coversheet
- Flowsheet, Patient Visit
- Information / Demographics Sheet
- Map: Labs on Heacock
- Medical Records Authorization Request (From Outside to LL)
- New Pediatric History Sheet
- Nurse Visit
- Opiate/Controlled Medication Agreement
- Phone Calls / Prescription Refills Note
- Pregnancy Test Note
- Progress Notes:
NOTE: Office staff may only complete "Reason for Visit"
| Generic Note | Comments BELOW the physical exam |
| Asthma Note | Note and Packet | |
| Diabetes Note | Packet | With Core Packet from Patient Education page |
| Physician Assistant | |
- Referral Information Sheet (for patients)
- Mental Health Services Slips
- Dental and Optometry (IEHP / Molina Providers)
- Optometrists, DM, Dialation Exam List (IEHP)
- Patient Information Sheet - Ambulatory Orders
- Student Note
- TB Risk Assessment - Patient Form: English | Spanish
- Test Results Line:
- Patient Cards: English | Spanish
- Overview | Operating Policy | Operating Protocol | Instruction Card
- Triplicate Replacement Policy
- Vaccines:
Other Forms
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