MCN’s customizable template, Nursing Intake Assessment Form, is taken from our Behavioral Health Partial Hospitalization Program Policy and Procedure Manual. MCN Healthcare’s proven policy and procedure templates, competencies and compliance tools have assisted more than 20,000 health care organizations worldwide meet their regulatory compliance goals.

MCN provides more than 80 health care specific policy and procedure manuals for Acute Care Hospitals, Ambulatory Care, Behavioral Health, Home Health, Physician Practice, and Long Term Care. MCN’s policy and procedure manuals focus on the latest healthcare "hot topic" issues related to patient safety and prevention of medical healthcare errors.

Here is some sample content from Nursing Intake Assessment Form:

	NURSING INTAKE ASSESSMENT Name: Legal Status: Precautions: Allergies: Occupation: Marital Status: Brought in by Whom: How: Height: Patient's Medical Health Aids: Comments: Chief Complaint and Date of Onset Recent Losses: Legal Issues/Court Dates: Family/Significant Others: Family Composition Relationship Significant Others Relationship MEDICATION PROFILE Prescribed Medication: Name Route Dose Last Taken Herbal Supplements/Home Remedies/OTC Medications: Type Route Frequency/Dose Last Taken Street Drugs/Alcohol: Type Route Frequency/Dose Last Taken Prior...
Second excerpt:
	...Following Items Were Completed: Orientation to program and staff Patient rights explained Patient's rights booklet given Milieu program explained Program rules explained Notification of patient's admission to next of kin If involuntary, advisement completed/explained/received Medication information given Patient accepts responsibility for own belongings Advance directives advisement given RN ASSESSMENT Neurological q Disoriented q Asphasic q Pupil...