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

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>-1854 NO LONGER A CHART FORM Multidisciplinary Treatment Plan - Mood Disorder DEACTIVATED 9/09<br />

<strong>HCH</strong>-1857 Multidisciplinary Treatment Plan - PHP/IOP Altered Health<br />

<strong>HCH</strong>-1858 Multidisciplinary Treatment Plan - PHP/IOP Discharge Planning<br />

<strong>HCH</strong>-1859 Multidisciplinary Treatment Plan - PHP/IOP Mood/Anxiety/Thought Disorder<br />

<strong>HCH</strong>-1860 Multidisciplinary Treatment Plan - PHP/IOP Substance Abuse/Dependence<br />

<strong>HCH</strong>-1965 Multidisciplinary Treatment Plan - Problem: Grave Disability (Psychiatry)<br />

<strong>HCH</strong>-1964 NO LONGER A CHART FORM Multidisciplinary Treatment Plan - Problem: Personality Disorder (Psychiatry) DEACTIVATED 9/09<br />

<strong>HCH</strong>-1966 NO LONGER A CHART FORM Multidisciplinary Treatment Plan - Problem: Risk <strong>of</strong> Violence (Psychiatry) DEACTIVATED 9/09<br />

<strong>HCH</strong>-1851 NO LONGER A CHART FORM Multidisciplinary Treatment Plan - Thought Process Altered DEACTIVATED 9/09<br />

<strong>HCH</strong>-1945 Multidisciplinary Treatment Plan (Psych)<br />

<strong>HCH</strong>-1123 NO LONGER A CHART FORM Multidisciplinary Treatment Plan Facesheet (Psych Inpt) DEACTIVATED 9/09<br />

<strong>HCH</strong>-1946 Multidisciplinary Treatment Plan Problem <strong>List</strong> (Psych)<br />

<strong>HCH</strong>-1978 Multiple Sleep Latency Test Questionnaire (Sleep Disorders Center)<br />

<strong>HCH</strong>-1977 Multiple Sleep Latency Test Technologist Log (Sleep Disorders Center)<br />

S. Banevicius/Tina Champagne,<br />

<strong>HCH</strong>-2398 My Discharge Plan (Sensory Diet: Crisis Intervention Worksheet) Jul-12<br />

copyright owner<br />

<strong>HCH</strong>-1066 NO LONGER A CHART FORM Myelomeningocele DEACTIVATED 10/2011<br />

Georg'Ann Bona/Cathy<br />

<strong>HCH</strong>-2345 Nail Surgery Wound Care Instructions Feb-12<br />

Sonnenberg<br />

<strong>HCH</strong>-1457 NO LONGER A CHART FORM Nasal Continuous Positave Airway Pressure Flowsheet DEACTIVATED 10/2011<br />

<strong>HCH</strong>-1088 NO LONGER A CHART FORM Nasogastric (NG) Tube Feedings DEACTIVATED 10/2011<br />

<strong>HCH</strong>-2339 Natalizumab (Tysabri®) Pre-printed Order Set Dec-11 Jessie Riemer<br />

<strong>HCH</strong>-683 Neonatal Abstinence Scoring Record Aug.-92 Sep-11 NICU/NBN<br />

<strong>HCH</strong>-587 Neonatal Intensive Care Flowsheet (NICU) - Order from warehouse (Moore) Jul-91 Feb.-01 Nursing<br />

<strong>HCH</strong>-1818 NO LONGER A CHART FORM Neonatal Intensive Care Respiratory Flowsheet (NICU) DEACTIVATED 10/2011<br />

<strong>HCH</strong>-809 Neonatal Neurological Assessment/Seizure Assessment Flowsheet 00-05 Sep-11 Nursing<br />

<strong>HCH</strong>-1321 Neonatal Nutrition Note Dec.-00 Feb.-06 Food & Nutrition<br />

<strong>HCH</strong>-495 Neonatal Parenteral Nutrition Fluid Orders May-87 Feb-08 Neonatology<br />

<strong>HCH</strong>-2290 NO LONGER A CHART FORM Neonatal Point <strong>of</strong> Care Testing (POCT) Reference Ranges DEACTIVATED 10/2011<br />

<strong>HCH</strong>-2212 Neonatal Skin Condition Score Dec.-09 Sep-11 S.Zaffetti<br />

<strong>HCH</strong>-2380 Neoral (Cyclosporine) Jul-12 Jane Grant-Kels<br />

<strong>HCH</strong>-960 Neurological Evaluation (Rehab) Sept.-06 Rehab Services<br />

<strong>HCH</strong>-1217 Neurological History <strong>and</strong> Physical Encounter Form (UMG) Sept.-98<br />

<strong>HCH</strong>-1475 Neuromuscular Speech Pathology Assessment Jul-06<br />

<strong>HCH</strong>-1775 Neurosurgery Encounter Sheet (UMG) 00-01 Jan-07 Neurosurgery<br />

<strong>HCH</strong>-2127 Neurosurgery History <strong>and</strong> Physical (UMG)<br />

<strong>HCH</strong>-2126 Neurosurgery New Patient Questionnaire (UMG)<br />

<strong>HCH</strong>-2125 Neurosurgery Re-Evaluation (UMG)<br />

<strong>HCH</strong>-1768 New Patient Breast Questionnaire (Cancer Center) Jan-07 Neag Cancer Center<br />

<strong>HCH</strong>-2299 New Patient Dispensation Apr-11 Jul-12 Kelly Clarke<br />

<strong>HCH</strong>-1771 New Patient Questionnaire - Gastroenterology/Hepatology (UMG) Dec-06 Ute Schroeder<br />

<strong>HCH</strong>-1643 New Patient Questionnaire Plastic Surgery (UMG) Jan-03 Dec-06 C.Sonnenberg-Surgery<br />

<strong>HCH</strong>-2268 Newborn Admission Discharge Examination Replaced by <strong>HCH</strong>-2313 Aug-10 Elaine Gerry<br />

<strong>HCH</strong>-1414 Newborn Eye Exam Order Sheet Nov-05 NICU<br />

<strong>HCH</strong>-1496 Newborn Hearing Screening Program Aug-06 Apr-12 T. Donovan-NICU<br />

<strong>HCH</strong>-1428 NICU March <strong>of</strong> Dimes NICU Family Support Dec-05 Clinical Operations Admin<br />

<strong>HCH</strong>-808 NICU NBN Digitalization Orders Oct.-93 Mar-04 Pediatrics<br />

<strong>HCH</strong>-807 NICU NBN Digoxin Maintenance Orders Oct.-93 Pediatrics<br />

<strong>HCH</strong>-1804 NICU Transitional Clinic History (UMG Neonatology)<br />

8/3/2012 - 9:53 AM 16/28

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