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Oncologist Template

Chemotherapy visit

A professional Oncologist template for healthcare professionals.
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Specialty

Oncologist

Used

29 times

Type

Note

Last edited

6/16/2025

Created by

Redmund Nel

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About this template

The Chemotherapy Visit template is a comprehensive documentation tool designed for oncologists to efficiently record patient information during chemotherapy sessions. This template includes sections for general patient data, blood test results, and any problems experienced with previous chemotherapy cycles, such as fatigue, nausea, and neuropathy. It also covers symptoms related to the underlying malignancy, examination findings, special investigations, dose adjustments, and additional changes in treatment. This template is ideal for oncologists seeking to streamline their documentation process and ensure all critical aspects of a chemotherapy visit are captured accurately.

Preview template

General: - Regime: FOLFOX - Cycle: 3 - Day: 1 - Blood Pressure: 120/80 mmHg - Weight: 70 kg Blood test results: - Haemoglobin: 13.5 g/dL - White Blood Cell Count: 4.5 x 10^9/L - Platelets: 250 x 10^9/L Problems Experienced with Previous Cycles of Chemo: - Fatigue Gr (NCI CTC): 2 - Nausea Gr (NCI CTC): 1 - Vomiting Gr (NCI CTC): 0 - Diarrhoea Gr (NCI CTC): 1 - Constipation Gr (NCI CTC): 0 - Oral Mucositis Gr (NCI CTC): 1 - Palmar Planter Erythrodysesthesia Gr (NCI CTC): 0 - Neutropenia Gr (NCI CTC): 1 - Febrile Neutropenia Gr (NCI CTC): 0 - Paraesthesia Gr (NCI CTC): 0 - Motor Peripheral Neuropathy Gr (NCI CTC): 0 - Sensory Peripheral Neuropathy (NCI CTC): 0 - Tinnitus: No Symptoms relating to underlying malignancy: - General Comments: Patient reports mild abdominal discomfort. Examination: - General Comments: Physical examination unremarkable. Special investigations: - CT scan of the abdomen shows stable disease. Dose adjustments: - General Comments: No dose adjustments required. Additional changes: - New antiemetic medication added to manage nausea. Next visit: - General Comments: Scheduled for 15 November 2024.

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