Headings
Screenings due · Screenings completed · Results reviewed · Immunizations due · Counseling · Plan
When to use it
Use this for a visit focused on catching up on age-based cancer screening, labs and vaccines outside the Medicare wellness format. It separates what is due from what is done and makes counseling a clear section, which helps when you are closing care gaps. It is lighter than an annual wellness visit and does not include cognitive or functional screens.
Example
Fictional example
Screenings due
M.O., 52. Mammogram, colon cancer screening, cervical screening, hepatitis C, lipid panel.
Screenings completed
Cervical cytology with HPV co-test collected today.
Results reviewed
Last lipid panel 3 years ago, LDL 141. Never screened for hepatitis C.
Immunizations due
Tdap booster, last dose 12 years ago. First shingles vaccine dose.
Counseling
Discussed stool test versus colonoscopy. She prefers colonoscopy. Reviewed alcohol intake, 4 drinks weekly.
Plan
Order mammogram, fasting lipid panel, hepatitis C antibody. Refer to gastroenterology for colonoscopy. Tdap and shingles vaccine today.