UM Upper Chesapeake Health 2025

1. Click ‘Get Form’ to open the UM Upper Chesapeake Health document in the editor.
2. Begin by entering the patient's name and date of birth in the designated fields at the top of the form.
3. Fill in the scheduled surgery date and anticipated surgery time, selecting the appropriate hospital from the options provided.
4. Indicate the anticipated patient status by checking one of the boxes for outpatient recovery or inpatient admission.
5. Complete the allergies section by referring to the Meditech Allergy screen for an authenticated list before administering any drugs.
6. Follow through each medication order section, checking off options as necessary and filling in dosage amounts where indicated.
7. For pediatric orders, ensure that all medication doses are written in mg/kg format as required.
8. Finally, have an authorized prescriber sign and date at the bottom of each page to validate the orders.

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