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Aide Supervisory Visit/Telehealth

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$24.10
QuantityPrice
1 – 4$24.10
5 – 9$20.80
10 – 14$17.20
15 +$13.70
SKU: 3554P
$24.10

UPDATED FEBRUARY 2022

This one-page form allows the appropriate skilled professional to document that the aide is furnishing care in a safe and effective manner.

If during the telehealth visit the skilled professional identifies an area of concern the form provides a place to document the situation and the date of a scheduled on-site visit if needed. The clinician may also document changes in the patient’s condition or care needs and the appropriate follow-up.

This form includes:

The time the call was started and ended

The type of device used to complete the call

The call participants

The aide’s presence or absence

The reason for the virtual visit

Pertinent follow-up interventions effecting the plan of care

Documentation of communication with the physician, if applicable


Download a sample today!

Size:  8 1/2" x 11"
Print:  1-side, black ink
Punching:   5-holes top and side
Packaging:  100 per pad

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