Get Pharmacist Assessment - Gerd Patient Name ... - Medsask - Medsask Usask

This guide provides a clear and supportive overview of how to fill out the PHARMACIST ASSESSMENT - GERD form online. Completing this document accurately is essential for effective patient assessment and treatment.

Follow the steps to efficiently complete the form.

1. Click ‘Get Form’ button to obtain the form and open it in your preferred editor.
2. Begin by entering the patient's name, address, and telephone number in the designated fields.
3. Provide the patient's medical history by selecting appropriate boxes for conditions such as renal dysfunction or hepatic dysfunction.
4. Indicate the patient's gender by selecting either ‘male’ or ‘female’, and fill in the date of birth (DOB) and health services number (HSN).
5. Complete the drug history section with details of both recent and current medication use, as well as any drug allergies.
6. Answer the patient history questions, indicating whether the patient is under 18 or over 50, pregnant, or taking any medications that could be causing symptoms. Use 'Yes' or 'No' options to navigate through these inquiries.
7. If the patient has previously been diagnosed with GERD, check the 'Yes' box; otherwise, select 'No'.
8. Detail any treatments the patient has tried in the past, specifying the treatment type and its effects.
9. Review the symptoms. Indicate if there are any alarm symptoms present and whether symptoms are consistent with GERD.
10. Assess symptom severity and recommend appropriate treatment based on the symptoms presented.
11. Complete the prescription information section, including rationale for prescribing, medication, quantity, and directions.
12. Fill out the counselling points to cover aspects like non-pharmacologic treatments and when to expect symptom relief.
13. Schedule follow-up information. Indicate how and when you will follow up with the patient.
14. Finally, enter details for the prescribing pharmacist, including names, contact information, and provide your signature and date.
15. Once completed, save your changes, and download or print the form as needed. You may also share the form with relevant parties.

Complete your PHARMACIST ASSESSMENT - GERD form online today for efficient patient care.