ZIMS for Medical Templates
These templates are intended to be filled out by a veterinarian, by hand or digitally, and then can be entered into ZIMS on behalf of that veterinarian. Within the digital record, list the Vet as the Author and then directly indicate within the text/note section for each record type, who entered the information into ZIMS for them.
Topics
In addition to these templates, additional downloadable templates for ZIMS for Medical are available here.
Revised 5 March 2025
Clinical Note Template
_________________________________________________________________________
Animal ID/house name: ____________________ Date: __________ Time: _________
Author/Veterinarian: _______________________
__ Significant note __ Private note
Health Status (circle):
Normal / Abnormal / Abnormal minor issue / Abnormal major issue
Diagnosis (include modifiers “otitis, left, ear”)______________________________________
Onset date of diagnosis: _______________
Note text:
Animal Care Staff Medical Summary: (Notes to share with Care staff):
_________________________________________________________________________
Animal ID/house name: ____________________ Date: __________ Time: _________
Author/Veterinarian: _______________________
__ Significant note __ Private note
Health Status (circle):
Normal / Abnormal / Abnormal minor issue / Abnormal major issue
Diagnosis (include modifiers “otitis, left, ear”)______________________________________
Onset date of diagnosis: _______________
Note text:
Animal Care Staff Medical Summary: (Notes to share with Care staff):
_________________________________________________________________________
Prescription Template
_________________________________________________________________________
Prescription :
Animal ID: _____________ Weight: ___________ Estimate? Y/ N (circle)
Date written: _____________ Start Date: ____________
Prescribed by: ____________________ Reason for Treatment____________________
Treatment Drug: ______________________ Drug Concentration: ____________
Form of Drug: Solid / liquid / semisolid / combination (circle)
Bottle #/ID/Lot #:__________ Expiration Date:_________
Dose amount: ________ Unit of Measure: _________ Frequency: ___________
Dosage amount: __________ Unit of Measure: _________ Delivery Route:_________
Duration: __________days / doses (circle) Delivery route__________
Administration dose quantity (include unit of measure): ________________
Instructions for Keepers:
_________________________________________________________________________
Prescription :
Animal ID: _____________ Weight: ___________ Estimate? Y/ N (circle)
Date written: _____________ Start Date: ____________
Prescribed by: ____________________ Reason for Treatment: _______________________
Treatment Drug: ______________________ Drug Concentration: ____________
Form of Drug: Solid / liquid / semisolid / combination (circle)
Bottle #/ID/Lot #:__________ Expiration Date:_________
Dose amount: ________ Unit of Measure: _________ Frequency: ___________
Dosage amount: __________ Unit of Measure: _________ Delivery Route:___________
Duration: __________days / doses (circle) Delivery route__________
Administration dose quantity (include unit of measure): ________________
Instructions for Keepers:
_________________________________________________________________________