Fillable Printable Sample Phone Message Template
Fillable Printable Sample Phone Message Template
Sample Phone Message Template
RoomNotification
To(O/C):Doctorcalledfor:
Caller'sName:
Hospital/FloorNumber:
PhoneNumber:
Patient'sName:Room#:
Doctorthatadmittedpatient:
Didyouverifyallinformation(y/n):
Date:Time:TakenBy:
RoomTransfer
To(O/C):Doctorcalledfor:
Caller'sName:
Hospital/FloorNumber:
PhoneNumber:
Patient'sName:
FromRoom#:
ToRoom#:
Haso/cbeennotifiedoftransfer(y/n):
Didyouverifyallinformation(y/n):
Date:Time:TakenBy:
Consult
To(O/C):DoctorCalledFor:
Caller'sName:
Hospital/FloorNumber:
PhoneNumber:DoctorRequestingConsult:
Patient'sName:
Patient'sRoom#:
Patient's
D/O/B:
Patient'sAge:
Whenpatientistobeseem:TODAY/AM/MON:
ReasonforConsultingPatient:
Didyouverifyallinformation(y/n):
VerballyGivento(PersonintheOffice):
Date:Time:TakenBy:
MessageTemplateSamples
Admit
To(O/C):Doctorcalledfor:
Caller'sName:
Hospital/FloorNumber:
PhoneNumber:
Patient'sName:Room#:
Doctorthatadmittedpatient:
ReasonfortheAdmit:
PatientHas/NeedOrders:DidYouVerifyAllInformation(y/n):
Date:Time:TakenBy:
NewBaby
To(O/C):Doctorcalledfor:
Caller'sName:
Hospital/FloorNumber:
PhoneNumber:
BabyGirl/BoyName(mother'slastname):
StatusofBaby:
Didyouverifyallinformation(y/n):
Date:Time:TakenBy:
BasicMedicalOfficeMessage
To(O/C):
Caller'sName:
Patient'sName:
PhoneNumber:
Message/Regarding:
Didyouverifyallinformation(y/n):
Date:Time:TakenBy:
MessageTemplateSamples
Doctor'sAlphaMessage
To(O/C):
Caller'sName:
Patient'sName:
PhoneNumber:
Patient'sPrimaryDoctor(inthisoffice):
Message/Regarding:
Didyouverifyallinformation(y/n):
Date:Time:TakenBy:
BasicMessageForm
To(O/C):
Caller'sName:
CompanyName:
PhoneNumber:
Message/Regarding:
Didyouverifyallinformation(y/n):
Date:Time:TakenBy:
MessageTemplateSamples
