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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
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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Please note that this checklist template is a hypothetical appuses-hero example and provides only standard information. The template does not aim to replace, among other things, workplace, health and safety advice, medical advice, diagnosis or treatment, or any other applicable law. You should seek your professional advice to determine whether the use of such a checklist is appropriate in your workplace or jurisdiction.