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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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Rated 5/5 stars on Capterra

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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