Client Medication Worksheet

Client Medication Worksheet

Description:

This report acts as a print-ready manual record of a client's medication information.

Use:

This report can be used by the agency to provide a physical copy of a medication sheet to either the client or a designated caregiver.

Limitations:

This report will not automatically populate most fields and is meant to be manually filled in after printing.

Filters

This report can be filtered by:

Field

Description

Company

The selected company.

Location

The selected location.

Admit Type

The code for the client's admission.

Team

The selected team.

Client

Client by name (last name, first name) or Sandata Client ID.

When a partial name is entered the report displays results that begin with the entered characters.

Client Status

The selected client status.

Date

The selected date.

ReportĀ Output

Each column of the report displays:

Field

Description

Client Name

The client's name (last, first).

Chart ID

The client's Chart ID number.

Social Security Number

The client's social security number.

Birthdate

The client's date of birth.

Sex

The client's designated sex.

Home Phone

The client's home phone number.

SOC Date

The client's start of care date.

Current Certification

The client's current certification period.

Client's Address

The client's primary address.

Case Manager

The client's case manager.

Physician

The client's primary physician.

Current Medications As Of

The client's current medication.

Pharmacy Information

The client's pharmacy information.

Disaster Code

The client's disaster group.

Nutrition/Diet

The client's nutrition/diet.

Allergies

The client's allergies (if applicable).

Medications

A table listing the client's medications.

New

Indicates if the medication is new.

Chg

Indicates if the medication has been changed.

DC'D

Indicates if the medication has been discontinued.

Effective Date

The date the medication is effective.

Medication/Dosage/Route

The name, dosage, and route of administration of the medication.

Indication

The condition that indicates the drug prescribed.

Diet (Comments/Notes)

Written notes regarding the client's diet.

Reviewed By

A signature field for the practitioner.

Date

The date of the signature.

Sample Report

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