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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>-1246 Patient <strong>and</strong> Family Teaching Record - Epilepsy Monitoring Oct.-98 Dec.-00<br />

<strong>HCH</strong>-1128 Patient <strong>and</strong> Family Teaching Record General Surgery<br />

<strong>HCH</strong>-1224 Patient <strong>and</strong> Family Teaching Record Herniorrhaphy Sept.-98 Sept.-00<br />

<strong>HCH</strong>-1375 Patient <strong>and</strong> Family Teaching Record Intrapartum/Post Partum 00-00 Dec-11 Sue Goodrich<br />

<strong>HCH</strong>-1377 Patient <strong>and</strong> Family Teaching Record Newborn<br />

<strong>HCH</strong>-1223 Patient <strong>and</strong> Family Teaching Record Oral <strong>and</strong> Dental Surgery Sept.-98 Sept.-00 J. Lounsbury<br />

<strong>HCH</strong>-1247 Patient <strong>and</strong> Family Teaching Record - Ostomy Teaching Oct.-98 Dec.-00<br />

<strong>HCH</strong>-1241 Patient <strong>and</strong> Family Teaching Record - Ovarian Hyperstimulation Oct.-98 Sept.-00<br />

<strong>HCH</strong>-1218 Patient <strong>and</strong> Family Teaching Record Port Cath Placement Sept.-98 Sept.-00<br />

<strong>HCH</strong>-1225 Patient <strong>and</strong> Family Teaching Record Port Cath Placement Sept.-98 Sept.-00<br />

<strong>HCH</strong>-1248 Patient <strong>and</strong> Family Teaching Record - Stroke Teaching Oct.-98 Dec.-00<br />

<strong>HCH</strong>-1227 Patient <strong>and</strong> Family Teaching Record Tonsillectomy Adenoidectomy Sept.-98 Sept.-00<br />

<strong>HCH</strong>-1228 Patient <strong>and</strong> Family Teaching Record Tympanoplasty Sept-.98 Sept.-00<br />

<strong>HCH</strong>-1229 Patient <strong>and</strong> Family Teaching Record Vein Ligation Stripping Sept.-98 Sept.-00<br />

<strong>HCH</strong>-2005 Patient Care Plan 00-05 Nov-10 Nursing<br />

<strong>HCH</strong>-867 Patient Controlled Analgesia Orders Feb.-94 Feb-.06 Anesthesiology<br />

<strong>HCH</strong>-1347 Patient Debriefing on Restraint Seclusion Nov-02 Sep-09<br />

<strong>HCH</strong>-1520 Patient Encounter Note - UMG Oct-06 UMG<br />

<strong>HCH</strong>-2059 Patient Health Questionnaire 9 (PHP)<br />

<strong>HCH</strong>-2157 Patient Health Questionnaire 9 (Psychiatry) Apr-09 Jun-09 Susan Richmond<br />

<strong>HCH</strong>-1314 Patient Information Sheet - Radiation Oncology Jan.-00 Sept.-09 Radiation Oncology<br />

<strong>HCH</strong>-2381 Patient Instructions - Chemical Peels (Superficial <strong>and</strong> Medium Depth) Post-Procedure Care Jul-12 Jane Grant-Kels<br />

<strong>HCH</strong>-2382 Patient Instructions - Chemical Peels (Superficial <strong>and</strong> Medium Depth) Pre-Procedure Instructions Jul-12 Jane Grant-Kels<br />

<strong>HCH</strong>-1937 Patient Instructions - Medication Dosing Schedule (UMG)<br />

<strong>HCH</strong>-1956 Patient Instructions - Ophthalmology Pre-Operative (Ophthalmology)<br />

<strong>HCH</strong>-2383 Patient Instructions - Photodynamic Therapy Jul-12 Jane Grant-Kels<br />

<strong>HCH</strong>-1260 Patient Instructions Geriatrics (UMG) Nov.-98 Jan.-07<br />

<strong>HCH</strong>-2128 Patient Intake Form Cardiology-Pulmonary Apr-09 Nov.-09<br />

<strong>HCH</strong>-1437 Patient Intake Sheet (UMG) Mar-06 Ute Schroeder-GI<br />

<strong>HCH</strong>-2265 Patient Medical History Aug-10 Linda Manzelli<br />

<strong>HCH</strong>-2144 Patient On Treatment Visit Note (Rad Onc)<br />

<strong>HCH</strong>-2136 Patient Planning Information - Rad Onc May-09 Nov.-09 Debra Litke-Rad Oncology<br />

<strong>HCH</strong>-1545 Patient Questionnaire - Electric Boat OCC MED Nov-06 S. Barnosky -Occ Med<br />

<strong>HCH</strong>-1777 Patient Questionnaire - Back Pain Follow Up (UMG OCC MED/Emp Hlth) Jan-07 S.Barnosky - Occ Med<br />

<strong>HCH</strong>-1549 Patient Questionnaire - Hearing Loss OCC Med Emp Health Dec-06 S.Barnosky - Occ Med<br />

<strong>HCH</strong>-1893 Patient Questionnaire - Indoor Environmental Quality <strong>and</strong> Health (Occ Med)<br />

<strong>HCH</strong>-1909 Patient Questionnaire Cumulative Trauma Disorders Upper Extremities (Occ Med)<br />

<strong>HCH</strong>-1998 Patient Questionnaire -Dermal Filler (Derm)<br />

<strong>HCH</strong>-1927 Patient Questionnaire International Prostate Symptom Score (Urology)<br />

<strong>HCH</strong>-1907 Patient Questionnaire Musician's Clinic (Occ Med)<br />

<strong>HCH</strong>-1929 Patient Questionnaire Pelvic Floor Impact (Urology)<br />

<strong>HCH</strong>-1553 Patient Questionnaire Pre Placement Exam OCC Med/Emp Health Dec-06 S.Barnosky - Occ Med<br />

<strong>HCH</strong>-2006 Patient Questionnaire PHYSIATRY HISTORY & TREATMENT POST SURG (ortho)<br />

<strong>HCH</strong>-2257 Patient Questionnaire for Speech Therapy Jun-10 Barbara Boucher-Rehab<br />

<strong>HCH</strong>-1884 Patient Rights Information (Psychiatry)<br />

<strong>HCH</strong>-2244 Patient Transfer H<strong>and</strong>-Off Communication Form (ISBAR) L&D/OB Gyn-Postpartum Apr-10 Sue Goodrich<br />

<strong>HCH</strong>-1345 Patient's Property Valuables/Transfer/Discharge Feb-98 Apr-12 Nursing / Dananne Vibert<br />

<strong>HCH</strong>-1555 Peak Flow Chart - Patient Reported OCC Med Employee Health Dec-06 S.Barnosky/Occ Med<br />

<strong>HCH</strong>-1887 Pediatric Ambulatory Surgery Discharge Instructions (FSC)<br />

8/3/2012 - 9:53 AM 20/28

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