The following forms have been sent in to be shared with other NPs and PAs in clinical practice.

You will need to have access to Microsoft Word and Excel, or download www.OpenOffice.org for a free office suite of software that can read and edit all the MS office documents. This program will also read and produced pdf documents as well. (We use this at my practice – works well). If you need a PDF reader, you can get one from Adobe.

I’ve placed the forms into a zipped file, which will download to your computer. It’s still large (almost 4mb), so if you have dialup, it will take a bit of time. Click ClinicalForms to download.

Thanks to our colleagues for their contributions:

From Venda Kelley, NP

• Encounter/Exam Form (excel)
• Coumadin Flow Sheet (excel)
• Consultation Request (excel)
• Animal Bite Form (word)
• Crash Cart Checklist (word)
• Health Maintenance Record (excel)
• TB Assessment for those with positive PPD (excel)

From Joseph W. Reis, NP

• Abnormal Involuntary Movement Scale  (pdf)
• Drug Hx (pdf)
• Psychiatric Intake Intake  (pdf)
• Mood Disorders Questionnaire  (pdf)
• Mood Chart (word)
• Progress Note  (pdf)
• Self Report  (pdf)
• South Oaks Gambling Screen  (pdf)

From Christine Smith, NP

• Adult Visit Note
• Pediatric Visit Note
• Procedures & Laceration Repair, I&D, Nebulizer Treatment

This folder will be updated as we add more forms to the mix. Eventually, I’ll put them into a pdf document for easier browsing.  If you have forms you’d like to share, please contact me on www.NPBusiness.ORG or send them, as an attachment to barbaracphillips (at) gmail (dot) com.

Thus far, three different NP’s have shared clinical forms with NPBusiness.ORG, 19 forms in total. We are looking to compile these forms into one downloadabe file, making it easier for all of us to access the forms we’d like.

In the meantime, here are three forms sent in by Christine Smith, NP of California. Two of them are in MS Word format and one in a .pdf format. If you do not have the free Adobe PDF reader, you can get it here.

To save to your computer, just right click and “save file to”.

• Adult Visit Note
• Pediatric Visit Note
• Procedure Note - for lacerations, nebulizer tx and I&D’s

If you have a form you’d like to share with other Advanced Practice Clinicians (NP’s and PA’s), feel free to contact me.

A wonderful resource of NP’s is the various email list that are under the umbrella of NP Central. There is so much teaching, learning, sharing and support that goes on – it’s truly amazing. I’ve been on those lists for at least the last 10 years (most likely more) and there is something I’ve seen over and over again.

Someone writes in looking for a specific tool. A helpful NP/PA responds by saying, I have that tool and I’ll send it to you. Pretty soon several more people most requesting a copy of said tool. The individual who offered to send it now has literally dozens and dozens of requests for the tool, and now spends hours trying to accommodate the multiple requests.

So when I recently received an email request from someone looking for a form, this idea came to mind, and I believe it will benefit all of us.Send me your tools (see contact info below) and I will put them all together into a pdf document/ebook that can be freely downloaded from NPBusiness.ORG . I’ll try and update the document on at least a monthly basis (as new tools are received). Please include the tool source and your name if you want to be credited for the tool. I’ll need your contact info as well in case I have any questions.

What kind of clinical tools?

• H&P Forms
• Registration Forms
• Encounter forms
• Decision trees/flow sheets
• Patient Teaching handouts on any subject
• Resource lists used in clinical practice
• Patient pain documentation
• Medication “contracts”
• Documentation templates

This list can go on and on but you get the idea. The point is to make this a useful tool for all NP’s and PA’s in clinical practice.

To participate, please send your form/tool along with the source of the tool and your contact information (in case I have questions, I will not publish your email/phone number unless your authorize it):

• You can email the documents to: barbaracphillips (at) gmail.com
• You can fax to my office: 360-538-1700 (Please make sure the copy is clean so it will scan well)

I look forward to all of us having a bit easier time in practice with tools that work.

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EDIT:  I was just reminded by Christine Smith, NP of California (Thank You!), that there is a book out by Lorraine Loretz, NP that brings togther several different clinical tools in one place.

Primary Care Tools for Clinicians: A Compendium of Forms, Questionnaires, and Rating Scales for Everyday Practice

I got an email from Carla asking the following question:

I would like to know if you know of a good source to get patient initial intake/history forms, and the demographic forms?  I would like to get a template that I can put my own name on.

This is what I did. I looked at several forms online, ones I had in files from years of holding on to this stuff, and some I even found as templates at Microsoft.  I put them together in a word doc, added the clinic name and printed them up. Of course, if you’d like, you can always purchase forms at places like MedicalArts Press. The Toolbox at Family Practice Management also has a list of various forms available. 

Something I’ve been thinking about is putting together a document with various forms. So for anyone reading, if you have a form you want to contribute, contact me and let me know about the form and if you can send it via email or fax it to my office. I’ll put the whole bunch of them into a PDF document that will be easy for everyone to download.