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A
Albuquerque Service Unit: Medical Record
- Prenatal and Pregnancy Flowsheet - Albuquerque Service Unit:
Medical Record
Alcohol Withdrawal Assessment Sheets (PIMC Apr 05) [WORD 140k]
Alcohol Withdrawal Protocol (PIMC Apr 05) [WORD 55k]
Asthma
card - child care, Allergy and Asthma Foundation of America
B
BTL form (bilateral tubal ligation) [PDF 331k]
C
PCC Comprehensive Elder Exam (IHS 865) [PDF
643k]
Credentialing and Privileging Guide, IHS, Revised 9/05 [PDF 999k]
Consent Forms
D
Domestic Violence
Diabetes in pregnancy checklist [WORD 53k]
E
Elder Exam PCC Comprehensive (IHS 865) [PDF
643k]
H
Hypertension in pregnancy checklist [WORD 49k]
I
Insulin Sliding Scale Inpatient
P
Elder Exam PCC Comprehensive (IHS 865) [PDF
643k]
PCC+ Forms for Women's Health and Prenatal Care
Please note: the Word documents are all about 160k and the
PDF's are about 50k.
PCC+ Web Page, Many Templates Available
Pneumonia
Admission Orders (PIMC) [WORD 38k]
Prenatal and Pregnancy Flowsheet - Albuquerque Service Unit: Medical Record
Prenatal assessment: ETOH,
Substances, Domestic Violence [PDF 24k]
Top
S
Sterilization Consent (30 day form) [PDF 331k]
Substance Abuse
Top
T
Tobacco Cessation Chart Form: Five A's
Tobacco
Cessation, Cherokee
Trial of Labor After Cesarean
- VBAC and TOLAC Consent Forms
Tubal ligation Consent (30 day form) [PDF 331k]
Top
V
VBAC and TOLAC Consent Forms
Top
Please note, regarding the material described above:
- The material presented is meant to further your local discussion of best practices. It is not meant to provide a template for care. Please share it with your local clinical staff and alter to fit your local needs
- Material for each topic on these sites has been developed by other providers based on that person's clinical judgment and experience as an expert in that field
- The material does not represent official policy or recommendations of the Indian Health Service or the other agencies involved
- Its publication should not be construed as excluding other acceptable methods of handling similar problems
- Please let the site coordinator know if you have questions or concerns about any of the material. Thanks
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