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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>-1134 Chemotherapy Teaching Nov.-97 Sept.-00<br />

<strong>HCH</strong>-2086 Chemotherapy Treatment Plan (Cancer Center)<br />

<strong>HCH</strong>-2041 Child <strong>and</strong> Adolescent Outpatient Disharge Summary (Outpatient Psych)<br />

Geraldine Pearson/Judy<br />

Lounsbury<br />

Geraldine Pearson/Judy<br />

<strong>HCH</strong>-2042 Child <strong>and</strong> Adolescent Outpatient Medication Mgmt Progress Note (Outpt Psych) Apr-08 Mar-11 Lounsbury<br />

Geraldine Pearson/Judy<br />

<strong>HCH</strong>-2043 Child <strong>and</strong> Adolescent Outpatient Medication Mgmt Treatment Plan (Outpt Psych)<br />

Lounsbury<br />

Geraldine Pearson/Judy<br />

<strong>HCH</strong>-2040 Child <strong>and</strong> Adolescent Outpatient Progress Note (Outpatient Psych)<br />

Lounsbury<br />

Geraldine Pearson/Judy<br />

<strong>HCH</strong>-2044 Child <strong>and</strong> Adolescent Outpatient Psychotherapy Progress Note (Outpt Psych)<br />

Lounsbury<br />

Geraldine Pearson/Judy<br />

<strong>HCH</strong>-2045 Child <strong>and</strong> Adolescent Outpatient Psychotherapy Treatment Plan (Outpt Psych)<br />

Lounsbury<br />

<strong>HCH</strong>-1916 Children's Sleep Questionnaire (Sleep Disorders Center)<br />

<strong>HCH</strong>-1554 Clearance Letter - Animal Contact OCC Med Employee Health Dec-06 S.Barnosky - Occ Med<br />

<strong>HCH</strong>-1551 Clearance Letter - Laser Eye OCC Med Emp Health Dec-06 S.Barnosky - Occ Med<br />

<strong>HCH</strong>-1547 Clearance Letter - Pre Placement UMG OCC MED Emp Hlth Nov-06 S.Barnosky - Occ Med<br />

<strong>HCH</strong>-1559 Clearance Letter Respirator OCC Med Employee Health Nov-06 S.Barnosky - Occ Med<br />

<strong>HCH</strong>-1400 Clinic Pre-Op Teaching Record Nov-04 UMG<br />

<strong>HCH</strong>-129A Clinical Context Data for Autopsy Oct-06 Nursing<br />

<strong>HCH</strong>-2221 Clinical Global Impression Jan.-10 R. Viens<br />

<strong>HCH</strong>-135 Clinical Record May-69 Feb-06<br />

<strong>HCH</strong>-2049 Clinical Record - Observation Nurse's Note<br />

<strong>HCH</strong>-2050 Clinical Record - Restraints/Seclusion May-08 Jun-11 Am<strong>and</strong>a Darcey<br />

<strong>HCH</strong>-550 Clinical Resume - Order from warehouse (Moore) May-89 Oct.-03 Nursing<br />

<strong>HCH</strong>-2152 Clinical Resume W10 (NBN) Jul-09 Oct-11 Terry Donovan<br />

Georg'Ann Bona/Cathy<br />

<strong>HCH</strong>-2301 Closed Wound Care Instructions May-11<br />

Sonnenberg<br />

<strong>HCH</strong>-1509 Colon Cancer Prevention Program Discharge Instructions Oct-06 Melissa Parente<br />

<strong>HCH</strong>-1815 Colonoscopy/Endoscopy Direct Booking Request with H&P Exam (Procedure Ctr)<br />

<strong>HCH</strong>-2349 Common Toxicity Criteria - Adverse Events (CTC-AE) Scales (NCI 2010) Mar-12 Jessie Riemer<br />

<strong>HCH</strong>-1910 Communication Letter (Ob/GYN)<br />

<strong>HCH</strong>-1212 Community Acquired Pneumonia Clinical Pathway Sept.-98 00-00<br />

<strong>HCH</strong>-2344 Comprehensive Spine Surgery New Patient Questionnaire Jan-12 Kelly Clarke<br />

<strong>HCH</strong>-1448 Confusion Assessment Method (CAM) Apr-06 00-00 K. Susco-Psych. Nursing<br />

<strong>HCH</strong>-1800 Congestive Heart Failure Encounter Note - Cardiology Mar-07<br />

<strong>HCH</strong>-1318 Conscious Sedation/Analgesia Flow Sheet - Order from warehouse (Moore) Oct.-00 Nov-11<br />

<strong>HCH</strong>-2279 Consent for the Administration <strong>of</strong> Chemotherapy Nov-10 Oct-11 Jessie Riemer<br />

<strong>HCH</strong>-969 Consent for Administration <strong>of</strong> Medication Sept.-95 Apr-06<br />

<strong>HCH</strong>-1680 Consent for Cardiac Stress Test Using Persantine (Spanish)<br />

<strong>HCH</strong>-1679 Consent for Echocardiography Stress Test (Spanish)<br />

<strong>HCH</strong>-1309 Consent for Electroconvulsive Therapy Dec.-89 Apr-06 Psych-ECT<br />

<strong>HCH</strong>-1682 Consent for Exercise Stress Test (Spanish)<br />

<strong>HCH</strong>-1681 Consent for Nuclear Exercise (Spanish)<br />

<strong>HCH</strong>-1508 Consent for Prenatal Analysis <strong>of</strong> Amniotic Fluid Cells (FISH) Oct-06 Nancy Maxwell<br />

<strong>HCH</strong>-2091 Consent for Radiological Imaging During Pregnancy Apr-08 Oct-11 Andres Sinisterra<br />

<strong>HCH</strong>-1567 Consent for Screening <strong>and</strong>/or Immunization for Minors OCC Med Dec-06 S.Barnosky - Occ Med<br />

<strong>HCH</strong>-2140 Consent for Treatment - Rad Onc<br />

8/3/2012 - 9:53 AM 6/28

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