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Forms & General Reference

These nursing and nursing-related forms can be viewed or printed using Adobe Acrobat.


Forms Committee Documents for Creation or Modification of Forms
  • Forms Committee Approval Form
    The above form must be completed whenever changes are made to forms which are placed in the patient chart (forms having an HCH number).  The hospital is currently converting to an electronic medical record (EMR), with associated forms being scanned for on-line access.  A copy of this approval form must be attached to a copy of the form being modified and submitted to Elena Albini, Health Information Management Dept, MC2925.  Once the changes are approved, a barcode will be placed on the form so that it is able to be scanned into the EMR.
  • Template for Chart Forms - Landscape
    The above form is the approved standard template for forms in landscape orientation.  A copy of this template in Microsoft Word format can be obtained from the Nursing Administration/ Administrative Support Office 860-679-2983.
  • Template for Chart Forms - Portrait
    The above form is the approved standard template for forms in portrait orientation.  A copy of this template in Microsoft Word format can be obtained from the Nursing Administration/ Administrative Support Office 860-679-2983.

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