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Saferating OceanView Demonstration Area

Anticoagulant (Warfarin) Clinic Tracking


Anticoagulant Clinic Record to document and manage patient encounters in a Warfarin (Anticoagulant) Clinic.


PFT is able to link a form with patient demographic to an encounter form to reduce duplicate entry.

Print a Progress ( SOAP) Note

Track PT values, INR, dosing and progress notes using our PFT document via the web, print your progress note and Fax a SOAP note to provider\'s office and populate a reportable database in minutes.
Search for patient encounter history during a clinic visit to better serve your patients.

 NOTE: Fields marked with "*" are required.
 

Patient Demographics

Intake or Initial Visit Information

Last Name*:
First Name*:
Medical Record Number*:
Date of Birth:
Phone Number Home:
Phone Number Work or Cell:
Home Address:
City:
Contact Person:
Contact Person Relationship:
Relation Phone Number:
Referring Physician*:
Diagnosis*:
ETOH Usage:
Tobacco Usage:
List medications seperate medications with a comma. ( Lipitor 10mg, Coumadin 5mg, Vasotec 5 mg)
Current Medications:
Primary Care Physician*:
Starting Dose:
Warfarin Start Date (mm/dd/yyyy)*:
INR Target*:
Anticipated Term of Therapy:


Clinic Visit or Encounter

This data will be utilized to generate your documentation "SOAP NOTE"

Current Dose*:
Current Complaint if any:
Please note medication changes on Progress Note
Changes in Medications?:
List any Medication Changes ( seperate with a comma)
Medication Changes:
Reports Changes to Diet?:
Bruising or Bleeding Reported?:
Patient Reports missing Doses?:
Current PT*:
Current INR*:
PT-INR is Within Therapeutic Range (2-3.5):
New Dose :
Progress Note*:
Next Appointment Date (mm/dd/yyyy)*:
Kept Appointment:
Pharmacist*:
       
     
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