Protocol for scheduling consults

Account:         New
Name:                 Name of patient and age
Phone:                XXX-XXX-XXXX
Doctor:        
App Types:        
C-Consult S.Lyon, CT- consult Troy

Notes:                Condition, diagnosed
                Relative (hus, wife, mom, dad) name, or driver
                  Email
                 How they heard about us
                 Initials of person who filled this out

Then after saved, email person the pre-consult questions. This is normally saved in your email under Canned responses.

*Please note you only can use about 150 letters. If you type a paragraph in the note section it will delete all words past its max. You will lose info. Please abbreviate when possible.

        

No

2:00 pm Steve Smith

21 YEAR OLD DAUGHTER WITH AUTISM AND BIPOLAR DISORDER

DIAGNOSED AT 18 YEARS OLD WITH BIPOLAR DISORDER

DIAGNOSED AT 6 YEARS OLD WITH AUTISM

JG

Yes

2:00PM Sarah Smith 21YO  

AUTISM AND BIPOLAR DISORDER

dx 6yrs W/AUTISM, 18yrs W/ BIPOLAR

dad -Steve Smith  

Ssmith@aol.com

WMUZ

JG