Microsuction Notes

← Go back

Patient Name (Edit if different to Client Name)Encrypted Field Restricted Encrypted Field Restricted
Client NameEncrypted Field Restricted Encrypted Field Restricted
Appointment Number470673
Pre-microsuction Otoscopy
Left EarEncrypted Field Restricted
Date of treatment//
Left Ear Issues
  • Encrypted Field Restricted
Left Other issue - please describe

Encrypted Field Restricted

Right EarEncrypted 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)
  • Encrypted Field Restricted
Left Ear (Post)Encrypted Field Restricted
Left Other issue - please describe (Post)

Encrypted Field Restricted

Right Ear (Post)Encrypted Field Restricted
Medical Referral
Medical ReferralEncrypted Field Restricted
Additional Practitioner Notes

Encrypted Field Restricted

Practitioner's Signature