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Forms to download

Installation instructions

  1. Download to a location such as the Window’s desktop
  2. Unzip the file and place it in the same location.
  3. Open the form designer from the Tools, Clinical Setup menu
  4. Click on [Import] and select the XML File
  5. Open Clinical Notes, go to the Forms Tab to locate and use.

Forms

Form Name (Click to download)DescriptionScreenshot (click to preview)
2Y Well Child CheckWell Child Screen appropriate for age 2 years
3M Well Child CheckWell Child Screen appropriate for age 3 months
3Y Well Child CheckWell Child Screen appropriate for age 3 years
4Y Well Child Check

Well Child Screen appropriate for age 4 years

 
5M Well Child CheckWell Child Screen appropriate for age 5 months
6W Well Child CheckWell Child Screen appropriate for age 6 weeks
15M Well Child CheckWell Child Screen appropriate for age 15 months
AcneAssessment and management of acne
Acute Asthmamypractice.co.nz/…/2Y-Well-Child-Check1.zipAssessment and management of acute asthma
Acute CandidiasisAssessment and management of acute candidiasis
Alcohol InterventionBrief intervention about alcohol consumption
Alcohol Readiness to changeMotivational interview about alcohol
Alcohol ScreenScreen for alcohol intake
Aldara creamEducation and guide to the application of Aldara cream
AlopeciaAssessment and management of male pattern alopecia
AnkleHistory and examination of ankles
Anti-coagulationReview Warfarin dosage
Asthma Control Test FormZip 
Atrial FibrillationAssessment and management of atrial fibrillation
Avian Influenza Bird FluAssessment and management of suspected avian influenza
Breast LumpHistory and examination of breast lumps
CBTTemplate for Cognitive Behavior Therapy
Cervical SmearAppropriate history and findings for cervical smear screening, update recall and create lab form
Chest PainHistory and examination of acute chest pain
ChlamydiaAssessment and management of chlamydia
Congestive Heart FailureAssessment and management of congestive heart failure
ConstipationAssessment and management of constipation 
CounsellingTemplate for recording a counselling session 
Cranial Nerve ExaminationRecording a cranial nerve examination
Decision BalanceTemplate for recording decision balance
Depression Beck InventoryBeck depression questionnaire
Depression CBTTemplate for recording a CBT counselling session
Depression Diagnostic Criteria 
Depression Review 
Depression Screen 
Dermatoscopy2 Step dermatoscopy analysis and recording 
   
Divers Questionnaire 
DysmenorrheaZip
Dyspepsia Heart-burnZip
ECGZip 
ECG ChecklistStep by step ECG Analysis 
EczemaZip
Emergency Contraception FormZip
Falls assessmentZip
Falls ScreeningZip
Fat Diet QuestionnaireZip
Foot CheckZip
Foot PainZip
FundoscopyRecord fundoscopy examination
GonorrhoeaZip
Gradual ProcessZip
Groin LumpsZip
Hair LossZip 
HeadacheZip
Health Check FemaleZip
Health Check MaleZip
HIV Pre-test CounsellingZip
INR Management FormZipINR Management (New)
INRZip
Joint PainZip
KneeZip
Limb Neurological ExamZip
Maternity InitialZip
Maternity PostnatalZip
MeningitisZip
Mental State ExaminationZip
Mental Test ScoreZip
Mini-Mental State Exam MMSEZip
Minor SurgeryZip
MiscarriageZip
Nail DiscolourationZip
Nails Plate SurfaceZip 
Neck LumpZip
Neurological Examination Rapid Neurological examination 
Osteoporosis RiskZip
Prostatism Lower Urinary TractZip
Red EyeZip
Red Rash AdultZip
Red Rash ChildZip
RhinitisZip
Scrotal LumpZip
Scrotal PainZip
Sexual Health FormZip
Sexual HealthZip
Shoulder PainZip 
Skin CheckZip
Skin Lesion Primary Care FormZip 
Skin LesionZip
Skin Sensitivity FormZip 
SleepZip 
Smoking ActionZip
Smoking InterventionZip
Stroke RiskZip
SuicideZip
Termination of PregnancyZip
ThyroidZip
Tiredness FatigueZip
TravelZip
TriageZip
Travel VaccinesZip
Varicose VeinsZip
Vascular AssessmentZip
Voucher Consultation FormZip 
Wound ManagementZip
 

2Y Well Child Check

Well Child Screen appropriate for age 2 years

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