Admission Note Short Template

Psychiatric Admission Note

PATIENT NAME:

DATE OF BIRTH:

MEDICAL RECORD #:

DATE OF ADMISSION:

DATE OF THIS EVALUATION:

IDENTIFYING INFORMATION:

ADMISSION LEGAL STATUS: Conditional voluntary

CHIEF COMPLAINT:

“   ”

HISTORY OF PRESENT ILLNESS:

PAST PSYCHIATRIC HISTORY:

  • Past Psychiatric Admissions:
  • Past Suicide Attempts:
  • Medication trials:
  • Trauma history:

OUTPATIENT MEDICATIONS:

OUTPATIENT TREATERS:

  • Prescriber:
  • Psychotherapist:
  • Primary Care Physician:
  • Other:

SUBSTANCE USE HISTORY:

PAST MEDICAL HISTORY:

ALLERGIES: No known drug allergies.

PHYSICAL EXAMINATION:

Hospitalist consulted to perform a standard physical examination upon admission; refer to hospitalist progress note for details.

LABORATORY DATA:

SOCIAL HISTORY:

FAMILY PSYCHIATRIC HISTORY:

MENTAL STATUS EXAM:

Appearance

Level of consciousness and orientation

Behavior

Attitude

Speech/thought process

Mood

Affect

Thought content (SI, HI, AH, delusions)

Cognitive functioning (eg., formal mental status exam assessing memory/concentration)

Insight

Judgment

ASSESSMENT:

DSM-5 DIAGNOSES:

INITIAL TREATMENT PLAN:

  1. Obtain collateral history …
  2. Medications…
  3. Medical issues…
  4. Aftercare planning….

NOTE:  The attending psychiatrist spent over 70 minutes during this clinical encounter, with greater than 50% devoted to counseling and coordination of care including review of records pertinent lab data and studies, as well as discussing diagnostic evaluation and workup, planned therapeutic intervention, and further disposition of care.

Published on 4/13/2020. Copyright 2020 Inpatient Psychiatry Today.