This customizable document, Telephone Discussion Record Form, is taken from MCN Healthcare’s Home Infusion Therapy Policy and Procedure Manual. For more than 20 years, MCN has been the health care industry’s leading provider of policy and procedure templates, forms, competencies and other compliance tools.

MCN’s templates save you time, money and resources, rather than developing healthcare policy and procedure manuals from scratch.

Here is some sample content from Telephone Discussion Record Form:

	TELEPHONE DISCUSSION RECORD Client Name: Date: Spoke with: Purpose of Telephone Call: Reason for discussion: General assessment Treatment/diet instruction Medication instruction Other: Assessment: Reported by client/family/caregiver Vital Signs: Medication Usage/Changes: Intervention: Plan: Next Telephone Discussion: Next Home Visit: Discharge: Last Physician Visit: Next Physician Visit: Signature/Title: ?? ?? ?? ?? 1 Reference #2117 Home...
Second excerpt:
	...Visit: Signature/Title: ?? ?? ?? ?? 1 Reference #2117 Home...