Master List of HCH Forms Currently Barcoded and - Department of ...
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>-2356 Refusal <strong>of</strong> Treatment/Service/Procedure Form Jun-12 Deborah Bugryn<br />
<strong>HCH</strong>-2149 Regional Anesthesia Record (Anesthesia) Jun-09 Jun-11 Carol Schramm<br />
<strong>HCH</strong>-1543 Registration Questionnaire UMG (Taste <strong>and</strong> Smell) Nov-05 M. Woodward<br />
<strong>HCH</strong>-1423 REHAB Daily Progess Note Nov-05 Jul-09 Rehab<br />
<strong>HCH</strong>-1504 Rehab Flow Sheet Aug-06 May-10 B. Boucher- Rehab<br />
<strong>HCH</strong>-1422 Rehabilitation Services Discharge Summary Nov-05 Oct-10 B. Boucher-Rehab<br />
<strong>HCH</strong>-1486 Rehab Patient Questionnaire Aug-06 B.Boucher-Rehab<br />
<strong>HCH</strong>-2249 Rehab Plan <strong>of</strong> Care May-10 B.Boucher-Rehab<br />
<strong>HCH</strong>-2252 Rehab Progress Note May-10 B.Boucher-Rehab<br />
<strong>HCH</strong>-1424 Rehab Re-Evaluation Nov-05 Rehab<br />
<strong>HCH</strong>-46A Rehabilitation Referral Dec-93 Jul-05 B.Boucher-Rehab. Services<br />
<strong>HCH</strong>-444 Release Form for Blood Components Sept.-96 May-05<br />
<strong>HCH</strong>-2385 Remicade (Infliximab) Jul-12 Jane Grant-Kels<br />
<strong>HCH</strong>-1797 Remote Transmission Reviewed Mar-07 Cardiology<br />
<strong>HCH</strong>-2353 Renal Biopsy Order Set Apr-12 Jessie Riemer<br />
<strong>HCH</strong>-1353 Request for Accounting <strong>of</strong> Disclosures <strong>of</strong> Protected Health Information Apr-03 I.Mauriello-Compliance<br />
<strong>HCH</strong>-1352 Request for Amendment <strong>of</strong> Health Information HIPAA Apr-03 Jun-12 I.Mauriello-Compliance<br />
<strong>HCH</strong>-1539 Request For Electrodiagnostic Testing Oct-06 Nov.-09 Orthopaedic Surgery<br />
<strong>HCH</strong>-1037 Request for Neurophysiologic Testing Apr-97 Sept.-09 Neurology<br />
<strong>HCH</strong>-1351 Request to Review Record/Notification <strong>of</strong> Approval or Denial To View Apr-03 Apr-11 I.Mauriello-Compliance<br />
<strong>HCH</strong>-852A Resident Database/Initial Evaluation (Psychiatry Inpatient) DEACTIVATED 5/2012 Apr-04 Mar-08 Nursing/Psych.<br />
<strong>HCH</strong>-1450 Resident Fellow Patient Encounter Form Sept.-98 Apr-06 M.Hein-UMG<br />
<strong>HCH</strong>-1848 Respirator Medical Evaluation Questionnaire OCC Med Emp Health<br />
<strong>HCH</strong>-1563 Respirator Medical Evaluation Questionnaire OCC Med Emp Health-Deleted Use <strong>HCH</strong>1848 Dec-06 S.Barnosky- Occ Med<br />
<strong>HCH</strong>-804 Respiratory Care Treatment Record Sept.-95 May-06 Resp. Care<br />
<strong>HCH</strong>-1739 NO LONGER A CHART FORM Respiratory Ventilator Sheets DEACTIVATED 10/2011<br />
<strong>HCH</strong>-1269 Restraint 1:1& Constant Observ.Flowsheet Acute Medical SurgicalReplaced by <strong>HCH</strong>2287<br />
<strong>HCH</strong>-2287 Restraint Monitoring/Observation (CO 1:1 Status) 15 minute Checklist Flowsheet Dec-10 May-12 Am<strong>and</strong>a Darcy<br />
<strong>HCH</strong>-1992 Retinal Drawing (Ophthalmology)<br />
<strong>HCH</strong>-1459 Return to Work or School - UMG<br />
<strong>HCH</strong>-1657 Return to Work Recommendations (UMG OCC MED/Emp Hlth)<br />
<strong>HCH</strong>-1560 Review <strong>of</strong> Tuberculosis Symptoms OCC Med Employee Health Dec-06 Feb-11 Janet Pinto OCC MED<br />
OB/GYN G. Muscillo/Kelly<br />
<strong>HCH</strong>-1529 Rheumatology New Patient Questionnaire UMG Sep-09 May-11 Clarke<br />
<strong>HCH</strong>-2047 Rheumatology Osteo Infliximab Pre-Printed Order Set<br />
<strong>HCH</strong>-1778 Risks <strong>and</strong> Benefits Consent Form (UMG Dermatology) Jan-07 S.Barnosky/OccMed<br />
<strong>HCH</strong>-764 Routine Newborn Orders - Newborn Nursery Apr-93 Apr-07 NICU/NBN<br />
<strong>HCH</strong>-2298 RN Visit - Sickle Cell Pain Apr-11 J. Riemer<br />
<strong>HCH</strong>-1056 Rule Out MI Orders Aug.-97<br />
<strong>HCH</strong>-1930 Sample Medication Patient Instructions (UMG)<br />
<strong>HCH</strong>-2174 Scheduled C-Section Flowsheet - Pre - Op Sept.-09<br />
<strong>HCH</strong>-1793 Scleroderma/CREST Test Schedule Instructions (Rheumatology)<br />
<strong>HCH</strong>-2386 Sclerotherapy Jul-12 Jane Grant-Kels<br />
<strong>HCH</strong>-875 SCO Myocardial Infarction Nov.-94 ICU<br />
<strong>HCH</strong>-699 NO LONGER A CHART FORM SCP Care <strong>of</strong> Growing Preemie DEACTIVATED 10/2011<br />
<strong>HCH</strong>-701 NO LONGER A CHART FORM SCP Care <strong>of</strong> Infant with Diaphgagmatic Hernia DEACTIVATED 10/2011<br />
<strong>HCH</strong>-704 NO LONGER A CHART FORM SCP Care <strong>of</strong> Infant with Myelomeningocele DEACTIVATED 10/2011<br />
<strong>HCH</strong>-703 NO LONGER A CHART FORM SCP Care <strong>of</strong> Infant with Necrotizing Enterocolitis DEACTIVATED 10/2011<br />
<strong>HCH</strong>-707 NO LONGER A CHART FORM SCP Care <strong>of</strong> Infant with Perinatal Asphyxia DEACTIVATED 10/2011<br />
8/3/2012 - 9:53 AM 24/28
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