SED Checklist (MH021_SED)

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Form Details

• Form Properties
  1. Form Title: SED Checklist
  2. Start from an Existing Form – No
  3. Copyrighted Form – No
  4. Billable Progress Note – No
  5. Have multiple versions open at same time – No
  6. Open Blank on new version – Yes
• Required Fields – None
• Lookup Tables – None
• Pre-Fill Logic – None
• Fill to Logic – None
• Signatures
  1. Signature of Therapist
     • Sig type: Any
     • Route-To is available.
     • Signature locks the form.

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SED Checklist Tab (1 of 2)

Complete checklist as directed.

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SED Checklist Tab (2 of 2)

Complete checklist as directed.

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Signature Tab

Signature Credentials (see Credentials - Create, Assign & Edit)

1. Signature of Therapist
   • Sig type: Any
   • Route-To is available.
   • Signature locks the form.

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