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Medword Resources:
Consultation Report Templates


Consultation Report Templates:
Template 7


These templates must be modified to be used in your particular word-processing program. Please refer to your program's "Help" guide to learn how to do this.



[Date] (Confirm whether to use date of patient visit, date of dictation, or date of transcription.)


[Name of Recipient]
[Address Line 1 of Recipient]
[Address Line 2 of Recipient]
[Address Line 3 of Recipient]
[Address Line 4 of Recipient]

Dear Dr. [Recipient Doctor's Name Here]:


HPI: This patient was seen on [Date of Patient Visit] with the history of

C/O:

H/O:

L/E of knees: - Right Left

Swelling:
Effusion:
Tenderness:
Flexion deformity:
Joint line tenderness:
Patellar tenderness:
Varus/valgus:
Range of movement:
Medial ligament laxity:
Lateral ligament laxity:
Cruciates:
McMurray's test:
"Q" angle:
Quadriceps wasting:
Power:
Patellar crepitus:
Retro patellar tenderness:
Distal pulsation:
Hips:

Clinical diagnosis:

Investigations:


Sincerely yours,[Or Other Closing]


[Signature Line or "Dictated But Not Read" Declaration]
[Doctor Name], [Doctor's Credentials]

[Doctor's Initials]:[Transcriptionist's Initials or Company Name]

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