Patient Counseling Evaluation Form

by Linda Krypel
This evaluation form was developed by Linda Krypel, Associate Professor of Pharmacy Practice at Drake University College of Pharmacy and Health Sciences. It includes a checklist of items that should be covered in a patient counseling session.

Portion of counseling components evaluated:
  • Identifies self properly
  • Purpose of session explained
  • Assesses prior knowledge (disease/treatment, initial s/s)
  • Concerns addressed (real or anticipated)

For the complete tool select Dowload Tool.




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