Templates
Medical
Triage Assessment Form
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Triage Assessment Form

1
Gather patient's general information
2
Identify the reason for visit
3
Assess the level of urgency
4
Determine patient's medical history
5
Check current medications and allergies
6
Measure vital signs including pulse, temperature and blood pressure
7
Perform physical examination
8
Approval: Physical Examination Results
9
Identify symptoms and their severity
10
Evaluate mental health status
11
Decide on the patient's priority level
12
Approval: Priority Level Decision
13
Document findings on the Triage Assessment Form
14
Share findings with attending physician
15
Approval: Physician
16
Give instructions to the patient based on the assessment
17
Record patient's comprehension of the instructions
18
Store the Triage Assessment Form
19
Monitor patient's condition based on the priority level
20
Reassessment if necessary