Microsuction Notes

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Patient Name (Edit if different to Client Name)Encrypted Field Restricted Encrypted Field Restricted
Client NameEncrypted Field Restricted Encrypted Field Restricted
Appointment Number470387
Pre-microsuction Otoscopy
Left EarEncrypted Field Restricted
Date of treatment//
Left Wax Occlusion %Encrypted Field Restricted
Left Ear Issues
  • Encrypted Field Restricted
Right EarEncrypted Field Restricted
Right Ear Issues
  • Encrypted Field Restricted
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 (Post)Encrypted Field Restricted
Right Ear (Post)Encrypted Field Restricted
Medical Referral
Medical ReferralEncrypted Field Restricted
Practitioner's Signature