Pediatric Wound Healing Progress Note

Patient Name:
Date of Birth:
Medical Record #:
Date of Visit:

Wound Assessment

Location:
Size (L x W x D):
Type of Wound:
Appearance:
Exudate:
Odor:
Surrounding Skin:
Pain (0-10):

Progress Since Last Visit

Improvement/Changes:

Current Treatment

Dressings Applied:
Medications/Topicals Used:

Plan & Recommendations

Next Steps:
Follow-up Date:
Provider Signature:
Date: