APPENDIX 9 - PATIENT'S FORMS
For a proper administration the use of standard forms is
recommended. Forms to be filled in by the patient or given to her
after the procedure should be available in different languages. By
using a computerised administration the forms can be generated for
every individual patient. This abolishes the need to print heaps of
forms and if some minor change must be made it is not necessary to
destroy the old forms.
The following forms may be used:
1. Patients fill in form:
own identification details
Name and address of her doctor
May she be contacted by letter or telephone
Consent to inform her doctor
5. Account of the termination procedure.
6. Medicines given.
8. Instructions for the patient before the procedure.
The first form includes consent to contact the patient at home.
In practice this is seldom necessary. But if you phone a patient, for
instance if she forgot her watch, and you get a husband who does not
know that his wife had an abortion, you cause and get much trouble.
It also asks for consent to inform her doctor.
Form number 8, instructions for the patient before she comes to
the clinic, contains such details as the exact place where the clinic
can be found, instructions to be starved in case of general
anaesthesia and so on.
Informing the doctor by letter is recommended. The letter gives
some details about the procedure and suggestions of the follow up
examination. If the attitude of the doctor is not known the letter
may contain the clinic number rather than the identification of the
patient. The patient should be instructed to visit her doctor and
mention the number. If you give the letter in the hands of the
patient, in my experience only a fraction of the letters reach the
doctor. Sending a letter by mail gives your clinic a good image and
your doctor knows where to send his next patient. The letter may
contain form number 8 for this purpose.