Individual Patient Treatment Records are a way for medical facilities to consolidate the treatments, observations, caregiver comments, and patient feedback into a single document that can be referenced throughout a patient’s duration at your location.
Data commonly included on this type of form can include blank for patient name, blank for caregiver name, date of treatment given, prompt for diagnosis code, medication administration record, body location indicator grid for mapping care, comments and description field, improvement index, and other useful reference information used to record observations and chart treatment given.
While stock versions are available and often used throughout the industry many facilities and pharmacies prefer to customize this document to accommodate their unique patient care needs and facility operational protocols. With no limitations on design and the ability to add any desired communication fields, notes, customized treatment logs, metrics for evaluation of treatment, and recording of improvement or decline let us know how we can assist in the design and delivery of a form to accommodate your unique facility needs.
- Freight additional using most economical carrier
- 1,500 forms per case
- Production time estimated at 10 days on repeat orders
- PAS manufactures Patient Treatment Record Forms for nurses, caregivers, facilities, hospices, and other healthcare professionals. The goal of this form is to document observations, incidents, comments, and other treatment events with the goal of improving patient care.
- 8.5" x 11" size
- Price per 1,000
- Packaged 1,500 per carton
- Portrait or Landscape Orientation Available
- Compatible with all major laser printers
- Printing available in up to 6 total colors
- White 28 leger paper but other weights available (price will vary)
- 5 and 10 hole punch available to fit common facility charts/binders
- Pricing includes standard 5 hole punch
- For 10 Hole Punch add $85 flat fee per order
- Unlimited potential for customization to suit the unique needs of facilities or pharmacies providing the record
- Differentiate yourself from your competition (most of whom use stock forms) by adding your branding and unique color scheme
- If you’re looking to copy an existing design you can submit a scan or image of your current form here.
- 8.5" x 11" Laser Cut Sheet
- 1,500 per case
- Priced per 1,000
- Up to 6 colors total
- Pricing includes 5 hole punch