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New Jersey Department of Health
MEDICAL AID IN DYING FOR THE TERMINALLY ILL ACT
ATTENDING PHYSICIAN FOLLOW UP Formfitting Instructions:
1. This form is intended for use by the Office of the Chief
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How to fill out attending physician follow up

How to fill out attending physician follow up
01
Gather all necessary documents and information.
02
Start by filling out the patient's personal information, such as name, address, and contact details.
03
Specify the reason for the follow-up and provide a brief overview of the patient's current condition.
04
Include any relevant medical history, previous treatments, and medications they are currently taking.
05
Document any symptoms or changes in the patient's condition since their last visit.
06
Provide a detailed examination of the patient, including vital signs, physical examination findings, and any diagnostic tests conducted.
07
Outline the treatment plan and any adjustments made based on the patient's response to previous treatments.
08
Include any recommendations or referrals to other healthcare professionals if necessary.
09
Sign and date the attending physician follow-up form.
10
Review the completed form for accuracy and completeness before submitting it to the appropriate department or healthcare facility.
Who needs attending physician follow up?
01
Attending physician follow-up is needed by patients who have had previous visits with the attending physician and require ongoing care or monitoring.
02
This may include patients with chronic conditions, those recovering from surgeries or treatments, or individuals with complex medical needs.
03
The attending physician follow-up helps ensure continuity of care, track progress, and make necessary adjustments to the treatment plan.
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What is attending physician follow up?
Attending physician follow up is a report completed by the attending physician to provide updates on the patient's condition and treatment.
Who is required to file attending physician follow up?
The attending physician is required to file attending physician follow up.
How to fill out attending physician follow up?
Attending physician follow up can be filled out by providing detailed information on the patient's progress, treatment, and any changes in their condition.
What is the purpose of attending physician follow up?
The purpose of attending physician follow up is to ensure continuity of care for the patient and monitor their progress.
What information must be reported on attending physician follow up?
Information such as the patient's current condition, treatment plan, medications, and any changes in their health status must be reported on attending physician follow up.
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