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Sample process for initiating a consultation or referral.
Sample policy stating that the clinic will provide consultations, referrals, or transfers to other health care professionals or settings when deemed medically necessary and/or will be considered at the patient's request.
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Advance directive description and policy in Spanish.
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General description and elements of an advance directive policy.

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Sample Clinic policy for offering and educating on advance directives to patients.
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Staffing ratios are a critical component of clinic productivity and business plans. This table shows one way to look at staffing ratios by estimating how many support staff is reasonable for each FTE provider in the clinic. Clearly this figure will vary depending on the type of practice (i.e. very heavy procedure oriented, high risk patients, a lot of obstetrics) but this example is a good "bench mark" for a basic primary care CHC doing full scope primary care with a primary care provider staff.
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Sample of one health center's prodictivity and revenue analysis used to determine staffing needs.
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Sample montly individual encounter report.
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Sample worksheet used to analyze provider staffing in a family practice setting.
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The purpose of this paper is to provide balanced information on the issue of physician productivity. It discusses how different organizations currently measure physician productivity and what they do with that information.
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Sample year-to-date medical encounter report. This is included to show an example of how encounter reports can be written.
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Sample forms to help calculate provider productivity incentives.
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A sample written provider productivity incentive plan.
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Medication refills may be approved by an RN with co-signature of licensed provider, according to the following guidelines.
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Sample policy for dispensing pre-packaged and sample pharmaceuticals.
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Sample policy describing the overall procedure for dispensing medication.
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Sample policy describing the mechanisms to procure patient medications.
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Sample health center pharmaceutical policy and procedure manual (10 pages).
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Sample policy outlining the documentation of medication refill requests.
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Written protocol outlining the process for handling prescription requests in the clinic.
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CSHS providers will provide to all patients who have undergone diagnostic studies their results in a timely manner.
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Sample procedure for copying OB records for Certified Nurse Midwives. The procedure includes copying OB records and closing OB files.
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Sample clinic policy to assure accurate and detailed record of all PPD testing in the clinic.
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Clinic policy describing SOAP notes.
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An after hours coverage system example/template developed by Shasta Community Health Clinic to facilitate 24 hour access to medical care for established patients.

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An overall medical records policy that includes content, organization, and location (PDF format).
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Sample clinic policy on Vaccine Administration Records to assure that there is an accurate on-going record of all vaccines administered in the clinic.
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