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Surgical Chart Audit Tool: Attestation or Review of History and Physical Mobile App

The Surgical Chart Audit Tool: Attestation or Review of History and Physical mobile app was designed to allow physicians and other select health care professionals to complete and document an Attestation or Review of History and Physical for surgical patients using an iPhone, iPad, or Android device.

The use of this tool will help prove that surgery is a medical necessity for a patient. The electronic signature capability allows any doctor to provide a handwritten signature directly in the app. Since the information is securely saved in the GoCanvas Cloud, you can easily save or print the medical records as a PDF to add to a patient's health records.

  • Lendlease
  • The Cooperative
  • PG&E
  • Toys R Us
  • Red Bull
  • Mirvac

Take a peek inside the Surgical Chart Audit Tool: Attestation or Review of History and Physical Mobile App

Included Features

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Included Fields

Customize to add, remove, or edit any of the fields below.

  • Ico date

    DATE:

  • Ico time

    TIME:

  • Ico multiline

    PRE-PROCEDURE DIAGNOSIS:

  • Ico statictext

    THE INDICATION FOR SURGERY IS AS STATED ABOVE.

  • Ico statictext

    THE HISTORY AND PHYSICAL HAS BEEN REVIEWED.

  • Ico checkbox

    There are no significant changes in the patient’s status which would impact the schedules procedure.

  • Ico checkbox

    There are no significant changes in the lab values would impact the scheduled procedure.

  • Ico multiline

    The following changes have occurred and are discussed below:

  • Ico signature

    PHYSICIAN’S SIGNATURE

  • ...and More!

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