Oncology Nursing Assessment Template
Patient Information
Name
Date of Birth
Medical Record Number
Date of Assessment
Oncology Diagnosis
Chief Complaint
History of Present Illness
Current Treatment
Type of Treatment
Chemotherapy
Radiation Therapy
Immunotherapy
Targeted Therapy
Surgery
Other
Details
Allergies
Vital Signs
Temperature (°C)
Heart Rate (bpm)
Blood Pressure (mmHg)
Respiratory Rate (bpm)
O2 Saturation (%)
Review of Systems
General
Gastrointestinal
Genitourinary
Neurological
Other
Physical Assessment
Pain Assessment
Pain Present?
Yes
No
Location & Description
Pain Score (0-10)
Psychosocial Status
Nursing Diagnosis / Plan