Triage Form

Please download the phone triage resources. There's a triage form and a triage procedure document. Also, ask your supervisor if you already have a triage form in-office that they want you to use. If so, get that form and have both of them in front of you as you complete this lesson. After completing this lesson you will bring both your current form (if you have one) and the example we’ve provided to your supervisor and/or your lead optometrist. They will review, revise (if necessary) and approve your custom form for use in your office.

Here's a critical point—remain consistent and methodical in completing your triage forms! Start with the patient demographics section at the top and don’t skip any fields. They are all necessary.

At the top of the form, you will complete the following:
Patient Name
Today's Date
Your Name
The Context

The Context of the injury or the situation.  Here's where you say to the patient, "Please tell me the purpose of this visit." Most likely the patient will go right to this, but not always! Sometimes a patient will just request an appointment without specifying the reason. Don't skip asking for the purpose of the visit. If they are vague, you can add "Are you experiencing any unusual or uncomfortable symptoms with your eyes?" If they say yes, then ask, "Tell me what happened or what you are experiencing…"

You'll see that there are two types of medical office visits listed along the left side of the form:

Emergency, meaning the patient must take action now.

Urgent, meaning the patient should be seen in the next 24 to 48 hours (but remember that just in time philosophy!)

The third kind of office visit is not listed on this form. This is the priority office visit, meaning it's important but not likely to be a sight-threatening situation.

Now let’s look more closely at the emergency and urgent sections of this form. As you speak with the patient you are listening for and using the key words and phrases you see here. Note the red squares in the Emergency section. These symptoms require immediate attention. You do not need to diagnose the patient’s problem. You are simply circling the fields on this form that apply, such as chemical burn or blurry vision. This information will be expanded upon by the technician and optometrist when they speak to the patient.