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We have a new OB/GYN and she would like a form for documenting LEEP's. Does anyone have one they are currently using that they would be willing to share?
Posted : September 15, 2016 6:07 am
Here is our form for the LEEP procedure. The text in the charts reads:
LEEP Procedure Performed:
HPI: HPI field
LMP: 08/02/2016; Birth Control: oral pills
Colpo Date: 08/08/2016
Colpo Results: Colpo Results field
Patient presents for LEEP Procedure for mild dysplasia. Informed consent obtained. LEEP procedure done after Betadene prep and paracervical block with 10 cc Lidocaine/ 1% Epinephrine. Patient tolerated procedure well. Good hemostasis achieved using cautery and Monsol's solution. Return to clinic in 4 months. Endometrial Biopsy: Endometrial biopsy done with ease. Pipelle curette. Patient tolerated procedure well.
Uterine Depth: 5 cm. Amount of Tissue Obtained: normal.
Posted : September 19, 2016 10:18 am
