Nurses Station Patient Care Report — Watermarks Camp

PATIENT CARE REPORT

PATIENT INFORMATION

Name

First Name

Last Name

Date of Birth

MM

DD

YYYY

Gender

Male

Female

Patient Group Name

INJURY/ILLNESS INFORMATION & TREATMENT

Chief Complaint

Nature of Illness or Mechanism of Injury

Treatment Performed

Medications Given

Assessment Findings

PROVIDER INFORMATION

Provider Name

First Name

Last Name

Provider Level of Training

Provider Affiliation

Watermarks Employee

Guest

Date of Care Given

MM

DD

YYYY

Time of Care Given

Hour

Minute

Second

Additional Notes