Remote health atlas forms

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Below is a list of some of the more commonly used forms in Primary Health Care. Additional forms are available via the relevant Atlas Item.

Central Australia Forms

Top End forms

Other Forms

 Electronic Health Record Forms

The following links provide the range of World Health Organisation growth charts endorsed for use in Northern Territory (NT) Department of Health health centres.

Healthy Under 5 Kids (HU5K) Program

 

Boys

Girls

Head circumference-for-age

Birth to 13 weeks

Birth to 13 weeks

Birth to 5 years

Birth to 5 years

Length-for-age

Birth to 6 months

Birth to 6 months

6 months to 2 years

6 months to 2 years

Height-for-age

2 to 5 years

2 to 5 years

Weight-for-age

Birth to 6 months

Birth to 6 months

6 months to 2 years

6 months to 2 years

2 to 5 years

2 to 5 years

Healthy School-Age Kids (HSAK) Program

 

Boys

Girls

BMI-for-age

5-19 years

5-19 years

Height-for-age

5-19 years

5-19 years

Weight-for-age

5-10 years

5-10 years

Supporting Reference Materials

Pharmacy forms are currently available on the information sheets page under the Pharmacy dropdown.

Accountable Drugs Quality Returns Template | word

 These Returns can be printed via
Quality Return Templates (combined set)
 and are to be completed each month.

Duress Alarm Respondent Details Quality Returns Template | 
word

Satellite Phones Quality Returns Template | word

Stryker® Stretcher Quality Returns Template | word

Vaccine Storage Quality Returns Template | word

Vehicles Quality Returns Template | word

Essential Checks Forms Template

 complete during each month

Personal Protection Equipment Kits Quality Returns Template |
word

 complete in April

Disaster Pack Quality Returns Template | word

 complete in October

Strive for 5 Vaccine Refrigerator Temperature Chart - complete during each month. 
Please write the name of health centre and which refrigerator on the Temperature Chart.                                                                             

Read information sheets on Point of Care Pathology for HemoCue Hb 201+ Quality Control Form

Last updated: 23 December 2016