Cache Health Quick Charting

Discharge instructions

Patient instructed to drink extra fluids today, avoid strenuous activity for 24 hours, leave the dressing on as instructed, and report dizziness, bleeding, chest pain, or shortness of breath.

Telehealth & Supervisory Care Disclosure

• The patient’s medical history, current concerns, and medications were reviewed. A collaborative care plan was developed to address the patient’s health goals, including discussion of risks, benefits, and alternatives. The patient voiced understanding and agreement with the plan.
• This visit was conducted within the scope of primary care. Additional diagnostic testing or specialty referral may be recommended as clinically indicated.
• Nursing services were provided pursuant to established clinical protocols and standing orders maintained by Cache Health and reviewed by the supervising provider.
• This encounter was conducted by Lauren Tree, RN, acting within her licensed scope of practice and under established protocols, with clinical oversight by Stephanie Sampson, DNP, APRN, FNP-C.
• This visit note reflects the supervising provider’s review, medical decision-making, and final plan of care.
• This encounter was conducted via telehealth. Patient identity was verified.
  • Patient location: Home in Utah
  • Provider location: Office in Logan, Utah
• Verbal consent for telehealth was obtained. The patient was informed of the risks, benefits, and limitations of virtual evaluation.
• Visit conducted via a HIPAA-compliant video platform.

Care Team & Supervisory Disclosure

• The patient’s medical history, concerns, and medications were reviewed. A collaborative care plan was developed with discussion of risks, benefits, and alternatives. The patient voiced understanding and agreement.
• This visit was conducted within the scope of primary care. Additional testing or referral may be recommended as clinically indicated.
• Portions of this visit were conducted by Lauren Tree, RN, within her licensed scope of practice and under established protocols, with clinical oversight by Stephanie Sampson, DNP, APRN, FNP-C.
• Nursing services were provided pursuant to established clinical protocols and standing orders maintained by Cache Health and reviewed by the supervising provider.
• This visit note reflects the supervising provider’s review, medical decision-making, and final plan of care.