Visit Notes Audit Visit Date(Required) MM slash DD slash YYYY Patient Initials(Required)Attending Doctor(Required)Auditing Doctor(Required)Visit NotesLegibility of writing(Required)Satisfactory (Yes/No) Yes No Auditing Notes / CommentsPresenting History / Exam(Required)Satisfactory (Yes/No) Yes No Auditing Notes / CommentsPast Medical History(Required)Satisfactory (Yes/No) Yes No Auditing Notes / CommentsRecent Travel History(Required)Satisfactory (Yes/No) Yes No Auditing Notes / CommentsOther Relevant History(Required)Satisfactory (Yes/No) Yes No Auditing Notes / CommentsDrug History(Required)Satisfactory (Yes/No) Yes No Auditing Notes / CommentsAllergies(Required)Satisfactory (Yes/No) Yes No Auditing Notes / CommentsClinical Findings(Required)Satisfactory (Yes/No) Yes No Auditing Notes / CommentsDiagnosis(Required)Satisfactory (Yes/No) Yes No Auditing Notes / CommentsManagement Plan(Required)Satisfactory (Yes/No) Yes No Auditing Notes / CommentsInvestigations(Required)Satisfactory (Yes/No) Yes No Auditing Notes / CommentsMedication(Required)Satisfactory (Yes/No) Yes No Auditing Notes / CommentsSafety Netting Advice(Required)Satisfactory (Yes/No) Yes No Auditing Notes / CommentsFollow-up(Required)Satisfactory (Yes/No) Yes No Auditing Notes / CommentsAll Sections Completed(Required)Satisfactory (Yes/No) Yes No Auditing Notes / Comments
