The TSWF Nursing Services AIM form is intended to be used by nurses and clinical support staff in adult PCMH clinics. The form is not designed for use in pediatric and non-PCMH immunization clinics.

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Training Material for All Users

AHLTA and other training resources

Additional TSWF support

Nursing Services Recent Changes

  • 9 changes for SEP-DEC 2018 update

Meds 2 Tab

  • Changed name of of IV Hydration ribbon to “IV Hydration/Lab Draw”
  • Added a new free text field to the ribbon with prepositioned text for Lab Draw
  • Added clinical clues for coding blood draw documentation. “CPT: 36415: Only when completing Venipuncture w/o inserting an IV. Do not use if in conjunction with IV insertion.”

Procedures 1 Tab

  • Relocated Adult Nursing Service Clinical clue field next to the Free text field.
  • Move “CPT: 93005: ECG With at Least 12 Leads; Tracing Only w/o Interp & Report” to the new field
  • Added to ECG clinical clues of:”CPT: 93041: ECG Rhythm strip; Tracing Only w/o Interp & Report“
  • Added to ECG clinical clues: “Use both CPT codes with rhythm strip. Only use CPT 93005 if performing an ECG without rhythm strip.”
  • Added G6PD as an exclusion criteria to the Dysuria SSP
  • Moved Immunization information from the top of the Pt Education tab to the Immunization tab of the Nursing Services forms to provide continuity

Sep-Dec Mid-Cycle Changes

  • Revision 1 – Returned Patient Accompanied and Chaperone fields to the Screening tab


  • Created June 2014
  • Standardize documentation
  • Intended use in adult PCMH clinics

The TSWF Nursing Services form was created in early 2014 and went live on the AHLTA Enterprise in June 2014. It was created to standardize the nursing services documentation of administered immunizations, medications, nursing procedures, and patient education & counseling performed at the point-of-service. The form’s intended use is acute, routine, or other scheduled patient visits in adult PCMH clinics.

Form Lead

TSWF-Nursing Services Form Lead
Scot Ario

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