Glendale Luxury Rehab

STAFF FORMS PAGE

  • SHIFT REPORT

    Fill this form out EVERY shift! This is important to keeping everyone informed of the daily issues, events and changes. When you click SEND, this will go out to the whole team.

    Shift Report Form

  • Narcotic Count

    Please use this form for Narcotic Counts. A new form needs to be filled out for every new RX number. Fill out top portion and print in order to sign. Double signatures required EVERY shift change count.

    Narcotic Count Sheet

  • Observation Log

    Download and print this observation log. Form is uploaded to KIPU.

    Observation Log

  • New Client Form

    Please fill out this form as soon as possible AFTER the client has arrived. Highlighted areas MUST be filled out. This is crucial for your client to get medications. Pressing send will go to management and the NP.

    New Client Form

  • Central Medication form

    For new patients fill out this form. Any medication either brought from home or prescribed after admission needs to be on this form.

    Central Medication form

  • Incident Report

    Incident Report is for whenever there is an unexpected event. This can include, med error, dropped medication, med count off, client fall/injury, staff injury, any 911 call, or any emergency event. Please contact Faith or Linda if unsure to fill out this form. Pressing send will send form out to the appropriate management staff.

    Incident Report Form