Home Health Wound Care Documentation
Patient Name
Date of Visit
Clinician Name
Patient ID
Wound Assessment
Wound Location
Wound Type
Wound Size (L x W x D in cm)
Wound Appearance
Periwound Skin Condition
Exudate Amount
None
Scant
Moderate
Heavy
Exudate Type
Odor
None
Slight
Moderate
Strong
Care Provided
Wound Cleansed With
Dressing Applied
Additional Interventions
Patient Response and Teaching
Patient Response
Teaching/Education Provided
Next Visit Date
Clinician Signature