To submit this form, you can send it via email to the designated supervisor's address. If applicable, you may also fax the completed document to the provided number. For online submissions, use the departmental online submission portal to upload your form directly.

Important dates for this form are not explicitly outlined, but it's advisable to stay updated on any academic deadlines relating to your surgical clerkship. Review your institution's calendar for relevant timelines.

The purpose of this form is to streamline the documentation process for surgical patients. It serves as a comprehensive guide for medical students to accurately record assessments and plans. By using this form, students can enhance their learning experiences and provide better patient care.

• 1. Patient History: Includes detailed patient background and previous medical records.
• 2. Physical Examination: Space to document the results of the physical exam.
• 3. Assessment: A section that allows for summarizing the patient’s condition.
• 4. Plan: Outlines the next steps in patient management.

If you fail to submit this form, you may miss critical evaluations or feedback essential for your training. Incomplete documentation can also affect patient care continuity and communication within the healthcare team.

• Delayed Feedback: Lack of submission may result in postponed evaluations from supervisors.
• Patient Management Issues: Inaccurate or incomplete information can hinder effective patient treatment.
• Academic Difficulty: Missing documentation may negatively impact your academic performance.

• 1. During Patient Consultations: Utilize this form to record initial assessments and H&P.
• 2. Surgical Notes: It's essential for documenting procedures and patient progress.
• 3. Educational Purposes: Use as a learning tool to improve your clinical documentation skills.