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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>-1826 Altered Health Nursing Care Plan (Dept <strong>of</strong> Psychiatry)<br />

<strong>HCH</strong>-1826A Altered Health Nursing Care Plan Addendum (Dept <strong>of</strong> Psychiatry)<br />

<strong>HCH</strong>-1772 Alternative Therapies Questionnaire (UMG) Dec-06 Ute Schroeder<br />

<strong>HCH</strong>-1515 Ambulatory Summary <strong>List</strong> Oct.-06 May-10 Ann Marie Capo<br />

<strong>HCH</strong>-2357 Ambulatory Summary <strong>List</strong> - Cancer Center Jun-12 Jul-12 Jessie Riemer/Georg'Ann Bona<br />

<strong>HCH</strong>-2350 Ambulatory Summary <strong>List</strong>: Pulmonary Apr-12 Georg'Ann Bona<br />

<strong>HCH</strong>-1819 Ambulatory Surgery Discharge Instructions (Farmington Surgery Center)<br />

<strong>HCH</strong>-1259 Ambulatory Surgery Pre-Op H&P Orders Feb.-99<br />

<strong>HCH</strong>-1371 Amniocentesis Dec.-03 Nov-11 Nursing<br />

<strong>HCH</strong>-1847 An Important Message from Medicare About Your Rights Aug-11 Cathy Cruz (Case Mgmt)<br />

<strong>HCH</strong>-1847S An Important Message from Medicare About Your Rights (Spanish version) Aug-11 Cathy Cruz (Case Mgmt)<br />

<strong>HCH</strong>-765 Anatomic Pathology Specimen Requisition Apr-93 Aug.-07 Pathology<br />

<strong>HCH</strong>-1159 Anemia Transfusion <strong>of</strong> Packed Red Blood Cells Jan.-98 Sept.-00<br />

<strong>HCH</strong>-675 Anesthesia Record - Order from warehouse (Moore) Anesthesiology<br />

<strong>HCH</strong>-774 Anesthesiology Orders: Adult Perianesthesia Care Jul-93 Jul-12 OR Carol Schramm<br />

<strong>HCH</strong>-1188 Anesthesiology Orders: Adult Perianesthesia - CARS Jul-93 Jan-12 Carol Schramm<br />

<strong>HCH</strong>-2330 Anesthesiology Orders: Adult Perianesthesia - ECT Nov-11 Carol Schramm<br />

<strong>HCH</strong>-774P Anesthesiology Orders For Pediatric Post-Anesthesia Care Unit (Replaced by <strong>HCH</strong>-2011) May-01 May-06<br />

<strong>HCH</strong>-2011 Anesthesiology Orders: Pediatric Perianesthesia Care Jan-08 Jun-11 Carol Schramm<br />

<strong>HCH</strong>-1343 Anesthesiology Pre Admission Questionnaire Nov.-02 Nov.-04 Anesthesiology<br />

<strong>HCH</strong>-1548 Animal Care Contact Questionnaire OCC Med Emp Health Dec-06 S. Barnosky - Occ Med<br />

<strong>HCH</strong>-1419 Ankle Evaluation Rehab Oct-05 Rehab<br />

<strong>HCH</strong>-2309 Annual Comprehensive Diabetes Foot Exam Jun-11 Georg'Ann Bona<br />

<strong>HCH</strong>-583 Antepartum Flowsheet (OB/GYN) Dec.-91 Jan-10 Nursing<br />

<strong>HCH</strong>-1803 Antepartum Record (UMG OB/GYN)<br />

<strong>HCH</strong>-1174 Antepartum Testing - Non Stress Test (UMG OB/GYN) Mar-98 Mar-07 N.Maxwell/OB GYN<br />

<strong>HCH</strong>-1410 Antepartum testing for Multiple Gestation May-05 MFICU<br />

<strong>HCH</strong>-1378 ANTEPARTUM TESTING FOR SINGLETONS Jul-02 Feb.-05<br />

<strong>HCH</strong>-1744 Antibiotics InfusionPre-Printed Order Set Dec-06 Dec-10 Jessie Riemer<br />

Anuja Durman/Anticoagulation<br />

<strong>HCH</strong>-1835 Anticoagulation Protocol/Collaborative Practice Agreement Jun-07 Jan-12 Clinic<br />

<strong>HCH</strong>-1811 Anticoagulation Service Encounter Note (Anticoag Clinic)<br />

<strong>HCH</strong>-1810 Anticoagulation Service Referral (Anticoag Clinic)<br />

<strong>HCH</strong>-1813 Anticoagulation Service Teaching Flow Sheet (Anticoag Clinic)<br />

<strong>HCH</strong>-1812 Anticoagulation Service Warfarin Dose Monitoring Flow Sheet (Anticoag Clinic)<br />

<strong>HCH</strong>-625 Apnea/Bradycardia Flowsheet Feb.-1992 Sep-11 Nursing<br />

<strong>HCH</strong>-2320 APRV Mechanical Ventilation Flowsheet Oct-11 Janet Schoenewolff<br />

<strong>HCH</strong>-1868 Aquatic Progress Note (Rehab) Jul-07 Apr-10 B. Boucher<br />

<strong>HCH</strong>-1655 Asbestos Patient Questionnaire (OCC MED) Nov-96 Nov-06<br />

<strong>HCH</strong>-1023 Asbestos Questionnaire Jan.-97<br />

<strong>HCH</strong>-1205 Asthma Acute Exacerbation Admission Orders Jun-98<br />

<strong>HCH</strong>-1206 Asthma Care Path Jun-98<br />

<strong>HCH</strong>-1204 Asthma Discharge Discharge Orders Jun-98<br />

<strong>HCH</strong>-1541 Audiogram UMG Nov-06 May-12 Elissa Wagner / Donna G<strong>and</strong>za<br />

<strong>HCH</strong>-1404 Authorization for Cystic Fibrosis Screening Apr-05<br />

<strong>HCH</strong>-2077 NO LONGER A CHART FORM Authorization for Hypothermia Treatment (NICU) DEACTIVATED 10/2011<br />

<strong>HCH</strong>-127A Authorization forTransfusion <strong>of</strong> Blood or Blood Products Apr-79 Oct.-09<br />

8/3/2012 - 9:53 AM 2/28

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