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Physician Order Sheets


R•J Health Systems
International, LLC
A Drug Information Company
The Doctor's Order form contains all the orders; medications (both regular scheduled and prn's), treatments, physical therapy, laboratory work schedules, diet, allergies, etc for each resident that has been ordered by the resident's attending physician, any covering physician and any consulting physician that must be followed for the continued care of that resident.

The Doctor's Order form is a four (4) part form consisting of:

  1. Part 1. This is the TOP sheet and is the permanent copy that must always stay with the resident's chart. (White Sheet).
  2. Part 2. This copy comes back to the producer on a day of the month specified by the facility containing any additions or deletions.(Canary Yellow)
  3. Part 3. This copy is for possible facility use, such as when a resident goes to an MD appointment. (Pink Copy)
  4. Part 4. This copy is removed upon review by the facility and may be sent back to the producer or kept by the DNS for internal reference. (Dark Yellow).
There are several areas on the MD Orders that we can put certain information.
  • Regular Scheduled Medications are those medications given on a regular basis. Could be once daily to once monthly.
  • Prn (as needed) Medications are given on an as needed basis any time during the month.
  • Treatments (Regular and Prn) are for daily care that is not considered a routine or Prn (as needed) medication
  • Lab Work is for scheduled laboratory work. Lists original date lab work ordered and frequency. For example: Electrolyte levels every 6 months, ordered 12-12-99. Reports are generated to notify staff when lab work should be drawn or conducted.
  • Special Instructions is for items that pertain only to a specific resident that do not need to be included (i.e. vaccines, PT, OT) on the kardexes for signature. Could also be used to keep records of self-administered medications, injections or vaccines, or if a resident can or cannot smoke.
  • Routine Instructions are orders (i.e. OTC meds that can be given per Nurse's Judgement) that pertain to all residents in the facility that do not need to be included on the kardexes for signature.

For additional information, please contact us at:

R•J Health Systems International, LLC