New Patient Information Worksheet Template

Each patient is required to fill out a New Patient Information Worksheet Template that includes such information as patient name, address, phone number, social security number, past medical history, past and present medication, any allergies to medication, medical insurance information, and a copy of the patient’s insurance card. A patient file must be made for each new patient in order to hold the paperwork required for the patient. One side of the folder should contain MDO101-1 NEW PATIENT INFORMATION SHEET, leaving the other side of the folder free for progress notes, lab work, and any other correspondence between doctors.

The file should be set up in such a manner so that the progress notes that the doctor writes for each new office visit will be directly on top of each other. The other sections should be tabbed with the appropriate headings and again be set up so that the most recent information will be at the top of the section. The patient information sheet needs only to be filled out on the patients first visit to the office. Any changes in patient information in subsequent visits may be updated directly onto the computer system. The computer system also helps to providing quick access to the billing records to resolve inquiries or problems from insurance companies or patients.

New Patient Information Worksheet Template Details

Pages: 02
Words: 161
Format: Microsoft Word 2013 (.docx)
Language: English
Manual: Medical Office
Procedure: New Patient Intake Procedure MDO101
Type: Form