Get Ph047 Caution Form Allergy Intolerance Status - Providence Health ...

The PH047 Caution Form Allergy Intolerance Status is essential for documenting allergy and intolerance information for individuals receiving care at Providence Health. Completing this form accurately ensures optimal safety and care for patients and facilitates effective communication across healthcare teams.

Follow the steps to fill out the form accurately and efficiently.

1. Select the ‘Get Form’ button to retrieve the PH047 Caution Form and open it in your preferred document editor.
2. Begin by filling in the initial assessment date at the top of the form to ensure that the documentation is current.
3. For the allergy/intolerance assessment, provide responses in the designated areas. Indicate if a history is unobtainable or fill out responses for each category: Drugs, Food, Latex, and Contrast Media.
4. Under the Drugs section, select the appropriate reaction status. If there is no reaction, mark 'None'. Also, indicate any contraindications related to maternity (breastfeeding, pregnant).
5. In the Food section, similarly, select a reaction status and ensure that any food allergies are entered into the SCM system as required.
6. For Latex, indicate 'Yes', 'No', or 'Unknown' based on the individual's status.
7. In the Contrast Media section, also choose 'Yes', 'No', or 'Unknown' as applicable.
8. Complete the source of information by specifying whether the data is from the patient/resident, an old chart/transfer form, or another source.
9. Fill in the printed name, updates date, signature, discipline, and college ID in the provided sections to validate the information.
10. If updates to the allergy/intolerance status are necessary, use the designated update section, drawing a line through any discontinued entries, and providing necessary signatures and dates.
11. Once all information is filled out, review the form for accuracy. Save your changes, then proceed to download, print, or share the completed form as needed.

Complete your PH047 Caution Form online to ensure effective communication and safety in patient care.