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Patient Assessment Checklist Template

With this template, a complete evaluation of the patient's condition can be made in any type of healthcare facility or see our SOAP note example checklist to follow SOAP patient interaction documentation.
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Patient Assessment Checklist Template

Patient Assessment

Primary Examination

Three questions

What Happened?

Where does it hurt most?

Can you take a deep breath?

SAMPLE

Signs and Symptoms

Allergies

Medications

Past Illness/Injuries

Last Intake of Food/Drink

Events Leading Up

Observations

Conscious State

Skin

Breathing

Pulse

Secondary Examination

Head to Toes

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