Pre-formatted Forms

Quick, helpful, handy risk management tools

Report Verification Stamp

In order to ensure appropriate processing and consistent management of medical information, i.e., test reports and pertinent documents requiring provider review, consider applying a stamp — maybe a variation of the stamp displayed below.

Instructions:

Physician or Provider initial the designated line upon review of the report and insert instructions for the nurse or MA, i.e., follow-up to be scheduled. Nurse or MA documents the follow-up appointment on the stamp. If no follow-up is needed write “NA” on the stamp. Be sure placement of the stamp does not obscure information contained within the report. All writing must be legible; if space does not allow, record follow-up information in a progress note or beside the stamp.

Date _______________ Dr. reviewed _________
Instructions _____________________________
Normal ____________ Call/notify____________
Abnormal__________ Pt aware _____________
Schedule follow-up __ Date ________________
Nurse/MA: acknowledge ___________________
Nurse/MA initial __________________________