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Master List of HCH Forms Currently Barcoded and - Department of ...

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Bar Coded <strong>Forms</strong> by <strong>HCH</strong> Number for eHIMS website.xls Sorted by Form Name<br />

<strong>HCH</strong>-1894 Infliximab (Remicade) Infusion Treatment Record (Dermatology)<br />

<strong>HCH</strong>-1898 Infliximab (Remicade) Pre-Infusion Patient Assessment Checklist (Derm)<br />

<strong>HCH</strong>-1752 Infliximab (Remicade) Pre-Printed Order Set Nov-06 Dec-10 Jessie Riemer<br />

<strong>HCH</strong>-1161 Influenza Group Immunization Consent Form Feb.-98 Sept.-09<br />

<strong>HCH</strong>-2180 Influenza Group Immunization Consent Form (H1N1) Oct.-09 N. Dupont<br />

Georg'Ann Bona/Cathy<br />

<strong>HCH</strong>-2335 Informed Consent 308-NM Ultraviolet B (UVB) Laser Phototherapy Dec-11<br />

Sonnenberg<br />

<strong>HCH</strong>-2004 Informed Consent - Allergy Testing <strong>and</strong> Treatment (UMG Otolaryngology)<br />

<strong>HCH</strong>-2063 Informed Consent - Ambulatory Services/Procedures<br />

<strong>HCH</strong>-2182 Informed Consent & Authorization for Admin. Of Anesthesia Services - Spanish Oct.-09<br />

<strong>HCH</strong>-1984 Informed Consent - Biopsy (JDH Derm) Dec-07 Apr-11 Cathy Sonnenberg<br />

<strong>HCH</strong>-1982 Informed Consent - Botox Injection for Spasodic Dysphonia (UMG ENT)<br />

<strong>HCH</strong>-1983 Informed Consent - Botox Injection for Torticollis (UMG ENT)<br />

<strong>HCH</strong>-2084 Informed Consent - Bronchoscopy<br />

<strong>HCH</strong>-2085 Informed Consent - Contrast Echocardiography - Calhoun Cardiology Center<br />

<strong>HCH</strong>-1979 Informed Consent - Electrodesiccation <strong>and</strong> Curettage (UMG Derm)<br />

<strong>HCH</strong>-2132 Informed Consent - Lumbar Puncture<br />

<strong>HCH</strong>-2002 Informed Consent - MOHS Micrographic Surgery (JDH Derm) Jan-08 Apr-11 Cathy Sonnenberg<br />

<strong>HCH</strong>-1981 Informed Consent - pH Probe Placement (UMG ENT)<br />

<strong>HCH</strong>-1980 Informed Consent - Pillar Palatal Implant (UMG ENT)<br />

<strong>HCH</strong>-1999 Informed Consent - Radiesse Dermal Filler (Derm)<br />

<strong>HCH</strong>-2001 Informed Consent - Restylane Dermal Filler (UMG Derm)<br />

<strong>HCH</strong>-2003 Informed Consent - Scissor Excision (JDH Derm) Jan-08 Apr-11 Cathy Sonnenberg<br />

<strong>HCH</strong>-2028 Informed Consent - V beam Treatment (Derm)<br />

<strong>HCH</strong>-2078 Informed Consent <strong>and</strong> Authorization for Administration <strong>of</strong> Anesthesia Services Sep-08 Apr-12 Carol Schramm<br />

<strong>HCH</strong>-1995 Informed Consent Asthma Exercise Challenge Test (Pulm Function Lab)<br />

Georg'Ann Bona/Cathy<br />

<strong>HCH</strong>-2341 Informed Consent: C<strong>and</strong>ida Dec-11<br />

Sonnenberg<br />

<strong>HCH</strong>-1993 Informed Consent Cardiopulmonary Exercise Test (Pulm Function Lab)<br />

<strong>HCH</strong>-1677 Informed Consent Dobutamine Stress Echo Testing<br />

<strong>HCH</strong>-1799 Informed Consent Exercise StresS Echo Testing Mar-07<br />

<strong>HCH</strong>-1801 Informed Consent Exercise Stress Test (Cardiology Center)<br />

<strong>HCH</strong>-2031 Informed Consent for Infliximab (Remicade) Infusion Therapy (Rheum Infusion)<br />

<strong>HCH</strong>-1808 Informed Consent for Laser In-Situ Keratomileusis (Lasik) (UMG)<br />

<strong>HCH</strong>-2226 Informed Consent for Psoralen Ultra Uva (Puva) Phototherapy Jan.-10 Nov-11 Cathy Sonnenberg<br />

<strong>HCH</strong>-2051 Informed Consent for Reclast (Zoledronic Acid) Infusion<br />

<strong>HCH</strong>-1925 Informed Consent for Total Body Skin Imaging (Derm)<br />

<strong>HCH</strong>-2089 Informed Consent for Transesophageal Echocardiogram (TEE)<br />

<strong>HCH</strong>-2227 Informed Consent for Ultraviolet B (UVB) Narrow B<strong>and</strong> Light Phototherapy Jan.-10 Nov-11 Cathy Sonnenberg<br />

<strong>HCH</strong>-1495 Informed Consent for Vaccination (Immunization) UMG Aug-06 Ute Schroeder-GI<br />

<strong>HCH</strong>-2066 Informed Consent for Zometa Infusion (UMG Rheumatology)<br />

<strong>HCH</strong>-1976 Informed Consent Infliximab (Remicade) Infusion Therapy (Derm)<br />

Georg'Ann Bona/Cathy<br />

<strong>HCH</strong>-2340 Informed Consent: Injection <strong>of</strong> Triamcinolone Acetonide Dec-11<br />

Sonnenberg<br />

Georg'Ann Bona/Cathy<br />

<strong>HCH</strong>-2342 Informed Consent: Laser Dec-11<br />

Sonnenberg<br />

<strong>HCH</strong>-1994 Informed Consent Methacholine Challenge Test (Pulm Function Lab)<br />

<strong>HCH</strong>-2029 Informed Consent Micro-Dermabrasion (Derm)<br />

<strong>HCH</strong>-1798 Informed Consent Nuclear Exercise Stress Test Mar-07<br />

8/3/2012 - 9:53 AM 12/28

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