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Provider Forms

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Anesthesia
Cancer
Cardiovascular
  Acute Coronary Syndrome Admission Orders
  Aquapheresis Ultrafiltration Heparin Orders
  Aquapheresis Ultrafiltration Orders
  CABG-Valve Transfer Orders
  Cardiac CT Angiography Orders
  Cardioversion Orders
  Code STEMI Inpatient Orders
  CT Cardiac Angiography Worksheet
  Definity Contrast Echo Orders
  Heart Cath Pre-Procedure Orders and Clinical Evaluation Validation for PCI
  Heart Cath Pre-Procedure Orders and Pre-Cath Validation for PCI
  Heart Cath Pre-Procedure Orders
  Heart Failure Orders
  Heart Surgery Intraoperative Orders
  Heart Surgery Post-Op Orders
  Heart Surgery Pre-Op Orders
  ICD/CRT-D Pre-Admission Data Worksheet
  Pacemaker-Dual Chamber Pre-Approval
  Pacemaker-ICD Insertion Pre-Op Orders
  Pacemaker-Single Chamber Pre-Approval
  Regadenoson (Lexiscan) Stress Cardiolite Orders
  Thoracic Surgery Post Procedure Orders
  Thoracic Surgery Pre-Procedure Orders
  Transesophageal Echocardiogram Post Procedure Orders
  Transesophageal Echocardiogram Pre Procedure Orders
  Treadmill Cardiolite Orders
Consent
ER
Forms
Home Health Hospice
MAR
  12 Hour MAR
  8 Hour MAR
  Acute Coronary Syndrome Admission MAR
  Adult Potassium-Magnesium IV Replacement MAR
  Alcohol and Drug Detox Pathway MAR
  Anemia Management-Adult Erythropoietin (Epogen/Procrit) Therapy MAR
  Anemia Management-Adult IV Iron Administration MAR
  Antepartum MAR
  Aquapheresis Ultrafiltration Heparin MAR
  CABG/Valve Transfer MAR
  Cancer Center - Intrathecal Pump Refill MAR
  Cancer Center - Orencia MAR
  Cancer Center - Port Flush MAR
  Cancer Center - Remicade MAR
  Cancer Center - Tysabri MAR
  CAPD MAR
  CCPD MAR
  Cesarean General Post-Op MAR
  Cesarean Post-Op Immediate MAR
  Code STEMI Inpatient MAR
  Comfort Care MAR
  Continuous Renal Replacement Therapy (CRRT) NxStage MAR
  Diltiazem (Cardizem) IV Drip MAR
  Endoscopy MAR
  Extubation Post Heart Surgery MAR
  Heart Cath Pre-Procedure MAR
  Heart Failure MAR
  Heart Surgery Post-Op MAR
  Heart Surgery Pre-Op MAR
  Hemodialysis Treatment MAR
  Heparin Protocol MAR
  Hospice MAR
  Hypothermia Post Cardiac Arrest MAR
  Hysterectomy Laparoscopy Robotic MAR
  Hysterectomy Laparoscopy Robotic Post-Operative MAR
  Insulin Intravenous Infusion MAR
  Insulin Sliding Scale MAR
  Intrathecal Narcotic MAR
  Neurointensive Care MAR
  Newborn Admission MAR
  Newborn Circumcision MAR
  Outpatient - Blood Transfusion MAR
  Outpatient - MAR
  PACU MAR
  Pain Protocol-Continuous Nerve Block MAR
  Pain Protocol-No PCA MAR
  Pain Protocol-Orthopedic Surgical with PCA MAR
  Pain Protocol-Shoulder Nerve Block MAR
  Pain Protocol-Surgical With PCA MAR
  Pain Protocol-With PCA MAR
  Plastic Surgery Post-Op MAR
  Postpartum MAR
  Sepsis MAR
  Thoracic Surgery Post Procedure MAR
  Total Hip and Revision Post-Op MAR
  Total Hip SAMA MAR
  Total Knee and Revision Post-Op MAR
  Total Knee SAMA MAR
  Total Shoulder and Revision Post-Op MAR
  Ventilator Adult Admisison MAR
Maternal Child
  Antepartum Orders
  Cesarean General Post-Op Initiate First Day Orders
  Cesarean Post-Op Immediate Orders
  Cesarean Pre-Op and Intra-Op Orders
  Consent for Elective Induction of Labor
  Elective Induction Information Sheet
  External Version Protocol
  Hypothermia for Hypoxic/Ischemic Encephalopathy Orders
  Magnesium Sulfate Administration Protocol
  Misoprostol (Cytotec) For Delivery After Second Trimester Fetal Demise Orders
  Misoprostol (Cytotec) For Induction Orders
  Newborn Admission Orders
  Newborn Circumcision Orders-Procedure Note
  NICU Admission Orders
  NICU Retina Examination Orders
  OB Triage Orders
  Oxytocin (Pitocin) Challenge Test Protocol
  Oxytocin (Pitocin) Induction/Augmentation Protocol
  Postpartum Orders
  PreEclampsia/HELLP Orders With Magnesium Sulfate Levels
  Prostaglandin Gel Protocol For Induction Orders
  Prostin E2 Suppository Protocol
Medical
Dialysis
  Alcohol and Drug Detox Pathway Orders
  C-Diff (Clostridium Difficile) Orders
  Diabetic Ketoacidosis Adult-HHNK Orders
  Hypothermia Post Cardiac Arrest Orders
  Outpatient Diabetes Skills and Management Training Orders
  Peripheral IV Starts with 1% Lidocaine Orders
  Physicians Orders and Progress Notes Post Procedure
  Physicians Orders and Progress Notes with Risks and Benefits
  Physicians Orders and Progress Notes
  Rapid Response Team Orders
  Restraint Orders
  Sepsis ED Orders
  Sepsis Orders
  Sepsis Screening Tool for Adult Patients
  Suicide/Psych Close Observation Orders
  TCU Admission Orders From Other Facilities
Neuro
Orthopedic
Pharmacy
Psychiatry
Pulmonology
Radiology
Rehab
Sleep Disorder Center
Stroke
Surgical
  Adjustable Gastric Band/Sleeve Gastrectomy Admission Orders
  Adjustable Gastric Band/Sleeve Gastrectomy Post-Op Orders
  Bronchoscopy Intra-Post-Procedure Orders
  Bronchoscopy Pre-Procedure Orders
  Cystoscopy Post-Op Orders
  Dental Repair Pre and Post Orders
  Endovenous Radiofrequency Ablation-Ambulatory Phlebectomy Pre-Op-Intra-Op-Post-Op Orders
  Endovenous Radiofrequency Ablation/Ambulatory Phlebectomy Pre-Op/Intra-Op/Post-Op Orders
  Extracorporeal Shock Wave Lithotripsy Post-Op Orders
  Extracorporeal Shock Wave Lithotripsy Post-Operative Orders
  Extracorporeal Shock Wave Lithotripsy Pre-Op Orders
  FESS Septoplasty Pre-Op Orders
  GYN Major First Post-Op Day Orders
  GYN Major Post-Op Orders
  GYN Minor Pre-Op and Post-Op Orders
  Hysterectomy Laparoscopy Robotic Orders
  Hysterectomy Laparoscopy Robotic Post-Operative Orders
  Laser PVP Urology Post-Op Orders
  OB GYN Admission Orders
  Outpatient History and Physical
  PACU Orders
  Plastic Surgery Post-Op Orders
  Tonsillectomy Post-Op Orders
  Tonsillectomy Pre-Op Orders
  Urology Post-Op Orders
  Urology Post-Operative Orders
Trauma

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  Microsoft Excel File
  Microsoft PowerPoint File
  Other File Type

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Acute Coronary Syndrome
Admission Orders

Heart Failure Orders

Pneumonia Orders

Sepsis Management Orders

Sepsis Resuscitation Orders

Sepsis Severe Screening Tool
for Adult Patients