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MCN ToolBox Entries

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STD/HIV/Hepatitis Risk Questionnaire

This is an integrated risk assessment form for STD, HIV, and hepatitis A, B, and C. The risk assessment form is designed to assess at-risk clients within your clinic and determine the services they should receive. This form is designed to be self-administered. Once the client has completed the form, it should then be reviewed by the clinic staff to determine the services the client is eligible to receive. In addition to screening, testing, and/or vaccine services, all clients should be offered appropriate counseling and educational materials tailored to their specific risks.

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Diabetic Foot Screen

A one-page diabetes foot screening form.
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Asthma Assessment Form

A sample asthma assessment form.
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Disipline / Termination

To outline procedures for discipline and / or termination of employees.

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Drug Free Policy

To maintain a safe work environment free of controlled substances.

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Court Attendance

To delineate the procedures for court appearances by employees.

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Confidentiality Policy

To maintain confidentiality of corporate and programmatic information.

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Bereavement Leave

To allow leave time for employees to attend funerals of immediate family members.

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Disaster Recovery Guideline

To assure relevance of the plan and ensure that all data is maintained and properly stored and all policies and procedures are followed to maximize recovery in the event of disaster.

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