Last Updated on 22nd June 2020 by Admin

Patient Name (Edit if different to Client Name)Encrypted Field Restricted Encrypted Field Restricted
Client NameEncrypted Field Restricted Encrypted Field Restricted
Appointment Number249343
Pre-microsuction Otoscopy
Left EarEncrypted Field Restricted
Date of treatment//
Left Wax Occlusion %Encrypted Field Restricted
Left Ear Issues
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Right EarEncrypted Field Restricted
Right Ear Issues
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Right Wax Occlusion %Encrypted Field Restricted
Microsuction Procedure Notes
Procedure Without Incident?Encrypted Field Restricted
Endoscopic?Encrypted Field Restricted
Hearing Test Performed?Encrypted Field Restricted
Post-microsuction Otoscopy
Left Ear Issues (Post)
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Left Wax Occlusion % (Post)Encrypted Field Restricted
Left Ear (Post)Encrypted Field Restricted
Right Ear Issues (Post)
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Right Ear (Post)Encrypted Field Restricted
Right Wax Occlusion % (Post)Encrypted Field Restricted
Medical Referral
Medical ReferralEncrypted Field Restricted
Practitioner's SignatureView Treatment Notes 1