RN & LVN. Must be refered by MD for DL who can assist students in registering 20 with ipledge. Acne PC Visit PC All All No No 20

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1 Abdominal Pain Accutane PC Visit PC Clinician Guidlines No No No Must be refered by MD for DL who can assist students in registering 20 with ipledge. Acne PC Visit PC All All No No 20 Direct students to the web for the SHC Evaluation & Treatment of ADHD Day PC, UC Clinician Guidelines No No No ADHD guidelines [HC 621]. If okayed by psych. To make an 0 appointment Use Rx Refill as the reason code. This is for Dx of Allergies not to be confused with Allergies Allergy Shots. See "Allergy Clinic Information Sheet" for process & requirements [HC 761]. Advise student to fill out their online questionnaire via Allergy Shot Initial Allergy Shot Initial AIT No No RN No 30 the Student Health Communicator. Allergy Shots Cont.* Allergy Shot Cont. AIT No No RN No See "Allergy Clinic Information Sheet" for process & requirements [HC 761]. * 30min appt. if restart (pt. not seen here before or has 15 not been here for more than 2 months) Anxiety Asthma Asymptomatic STI/STD Audio Back Pain Blood in Stool RN's preferred for this type of appointment. RN=15min, PC=20min. Nurse, AIT AIT, PC Please advise student to visit the STD Testing Wizard via the Student Health Center website. Also offer the Self Directed lab, PC Visit All All RN No 15/20 testing and SHOP as options. Nurse, AIT AIT No No Yes Yes 20

2 BP Check Breathing problem Chest pain CAPS Referral Constipation Nurse, AIT, PC Visit AIT, PC All All RN No 15/20 If for hormone contraception please refer to the contraception appointment guidelines. RN=15min, PC=20min F/U visit without acute symptoms can be scheduled as an appointment. Acute sx's direct to UC Same Day. F/U visit without acute symptoms can be scheduled as an appointment. Acute sx's direct to UC Same Day. use CAPS designated slots for Same Day first. Consultation PC Visit PC All All No No 20 Use this for any consults and in comments indicate weather it's for IUD, Colpo or Derm. Refer to Clinician Schedule Guide. Also put the referring clinicians name in the comments COPE COPE- AIT, COPE-Nursing See Contraception Appointment Guidelines. Please advise student to review Contraceptive Options via the Student Health Center website. Please advise student to fill out online questionnaire via the student health communicator as it will expedite their AIT, PC No* No* RN No appointment. *If they have been waiting ( on the wait list) for an 30 appointment greater than 2 weeks please schedule with PC. Depo Depression Student must have annual of less than 1 year and order for DEPO by a clinician either from the SHC or documentation of annual with pap and order of DEPO. If student has had an annual but no order for DEPO make a Change of Birth Control. If everything is from the outside, we must have all documentation of annual, with pap, order Nurse, AIT AIT, RN All All RN No for DEPO and date of last shot. In the, Immunization 15 and under Additional type in DEPO. See Depo Calendar.

3 Diabetes Please advise student to fill out online questionnaire via the student health communicator as it will expedite their Diabetes-Followup PC All Monihan No No appointment. Only have established Judy Monihan Diabetic 40 patients fill out questionnaire. Diabetes - Initial Diabetes-Initial PC All Monihan No No Please advise student to fill out online questionnaire via the student health communicator as it will expedite their appointment. Only have established Judy Monihan Diabetic 40 patients fill out questionnaire. Diarrhea Day PC All All No No 20 Dressing Change Nurse, AIT, PC Visit AIT, PC No No Yes No 15 AIT, No No Yes Yes 30 Referral Required Nurse, AIT Ear Lavage Ear Problem Eczema PC Visit PC All All No No 20 ED-Follow-up* ED- Follow-Up* PC Clinian Guidelines No No No 40 *Refer to Clinician Guidelines for ED Team. Be sure to put "307" in the comments. IM Beth Hyde if appointment is cancelled. 307's with private insurance. If students choose not to make an appointment, ask if we could have Beth Hyde call them, to help facilitate outside of UCSC. Please IM her with the information. ED-Initial* ED- Initial Visit* PC Clinican Guidelines No No No 40 *Refer to Clinician Guidelines for ED Team. Be sure to put "307" in the comments. IM Beth Hyde if appointment is cancelled. 307's with private insurance. If students choose not to make an appointment, ask if we could have Beth Hyde call them, to help facilitate outside of UCSC. Please IM her with the information.

4 *Be sure to put "307" in the comments. IM Beth Hyde if Yes ED-Vitals* PC Visit PC/RN No No No 20 appointment is cancelled EKG Nurse, AIT AIT No No Yes Yes 20 Referal Required Eye Problem Fatigue Day PC All All No No 20 Fever *State reason in comments, if not provided write "personal" also note blue slips and MD who referred. If a F/U from the ER be sure to Follow-up* PC Priority/ Follow-up PC All All No No get records a.s.a.p. & make comment in the appointment notes 20 that records have been requested. Hand/Finger pain Headache PC Visit, Travel 15/20/ Health Clearance * 15, Travel 30 AIT All All RN No 30 * See Health Clearance Guidelines. Hormonal Recheck PC Visit, Nurse, AIT PC, AIT All All No No Follow-up to initial contraception appointment. Please consult 20 Contraception Appointment guidelines under Women's Health. Immunization AIT should be the primary choice when scheduling. Refer to the AIT, Nurse AIT, RN No No Yes Yes AIT/RN/ Guidelines. Note immunization types in 15 comments. 's require clinician orders. Integrative Integrative Medicine Medicine PC Hughes No No No Must have referral. Be sure to tell the patient to bring all meds, herbs 40 & supplements they are taking with them. Injection Medication Nurse, AIT AIT, RN No No RN No Examples of Medications are: testosterone, avanex, B12 - not to be 15 confused with Depo, allergy shots, immunizations etc... INJURY- Ankle/foot

5 INJURY- Hand/wrist INJURY- Head/neck INJURY- Knee/leg Day PC,UC All All No No 20 INJURY- Shoulder/arm Joint Pain Knee Problem Laceration/abrasion Mole Ck PC Visit PC MD Only No No No 20 Nausea/Vomiting Nutrition: Consult Nutrition Visit Nu Nancy Jackson No No No 45 If initial appoint ask them to bring a 1 week food journal. Nutrition: Gastric Disease Nutrition Visit Nu Nancy Jackson No No No 45 Nutrition: Weight Management Nutrition Visit Nu Nancy Jackson No No No 45 Nutrition: ED Nutrition Visit Nu Nancy Jackson No No No 45 IM Beth Hyde if appointment is cancelled Nutrition: Diabetes Nutrition Visit Nu Nancy Jackson No No No 45 Nutrition: Cholesterol Nutrition Visit Nu Nancy Jackson No No No 45 Pregnancy Test UC Same Day PC All All No No 20 May have a follow up with an RN or AIT Procedure PC Procedure PC Clinician Guide No No No Indicate in comments what type of procedure you are 40 scheduling PX Athletic PC Visit PC All All No No 20

6 PX Clearance PC Visit PC All All No No 20 PX DMV PC Visit PC All All No No 20 PX General PC Visit PC All All No No 20 May need RN visit first to order required labs and diagnostic tests, e.g. Antarctica and Fulbright scholarship (labs only = 15min Labs & EKG, Audio = 30min)Ask if they have their paperwork filled out? Remind patient to bring in their paperwork. If the patient is an employee of UCSC remind them to have the Recharge Form sent to billing (Teresa Dunn) prior to appointment. Order Labs. Specify in comments "UCSC" vs. "NOAA". See Diving [Scuba] guidelines. If the patient is an employee of UCSC remind them to PX Diving [SCUBA] PC Visit PC All All No No have the Recharge Form sent to billing (Teresa Dunn) prior to 20 appointment. Rash Note in comments what medication. Also ask if they have already checked in the pharmacy to see if they have refills Rx Refill UC Same Day, PC Visit UC, PC All All Yes No available. If ADHD meds refer to ADHD Guidelines and put 20 ADHD in comments. Skin lesion Spirometry Spirometry AIT No No No Dave AM appointments only. Screening Spiros only (NOAA SCUBA) all 30 others are referred out. STD SYMPTOMS STD-Results Suture Removal* PC Visit, Nurse PC, RN All All Yes No 15/20 If negative results are given via the student health communicator. If positive or of concern it is addressed by clinician. * prefer records of Tx if sutures where not placed at UCSC. If a F/U Nurse, AIT AIT No No Yes No from the ER, be sure to notify Medical Records to get the records 15 asap & make comment records have been requested.

7 Swollen Glands PC Visit, PC Same TB-read UC Same Day UC No No Yes No hours after placement. No longer scheduled as apt. Pt. can walk in and be seen in Triage between 9 and 11 a.m. TB-test Monday, Tuesday, Wednesday & Friday ONLY! If an employee of UCSC or CAL Teach remind them to have their Recharge Form sent to Billing (Teresa Dunn) prior to appointment. Also note in comments the program they are with (Cal Tech). Please advise student to fill out online questionnaire via the Student health TB-Nursing, TB- Communicator prior to appointment as it will expedite their AIT AIT, RN No No Yes Yes 15 visit. 's need clinician orders. TG - M to F TG - F to M TG - Follow Up PC See Clinician Guide No No No 20 Be aware of preferred Name TG - M to F TG - F to M TG - Initial PC See Clinician Guide No No No 40 Be aware of preferred Name Travel (EAP)* Can NOT make an EAP appointment unless the online EAP Health History has been reviewed by an a plan has been made via secure messaging. * Ask them to bring immunization records. Include country in comments. Be sure to check Open Chart for EAP plan. Please advise student to fill out online questionnaire via the Student health Communicator prior to Travel 15, Travel appointment as it will expedite their visit. Inform the patient that 30 AIT No No RN No 30 they may need to return for additional appointments.

8 * Ask them to bring immunization records. Include country in comments. Students must fill out online questionnaire via the Student health Communicator prior to appointment as it will expedite their visit. If F/U note in comments & they are NOT Travel (Non-EAP)* Travel 15, Travel 30 AIT No No RN No required to fill out the questionnaire. Inform the patient that they may 30 need to return for additional appointments. URI Urinary Symptoms Wart tx PC Visit PC All All No No 20 Will likely be genital warts If no Dx RN will consult with time of appointment. NON Wart tx Wart Treatment AIT All All RN No 30 Genital only Weight Concerns PC Visit PC All All No No 20 Well Women Exam. Under 21 PC WH Annual ExaPC Well Women Exam 21+ PC WH Annual ExaPC Not back-to-back. Please see W/H Guidelines. Limit of 3 per day. We ask that they are not on they're period and to not have sex or use Female clinicians preferred; All MDs by request only. All No No anything vaginally 24hrs prior to their appointment. Also to please log into the Student health communicator to fill out the online 20 questionaire. Not back-to-back. Please see W/H Guidelines. Limit of 3 per day. We ask that they are not on they're period and to not have sex or use Female clinicians preferred; All MDs by request only. All No No anything vaginally 24hrs prior to their appointment. Also to please log into the Student health communicator to fill out the online 20 questionaire. WH -BC change PC Visit PC All All No No 20 Ask of they had a pap within the last year. If yes, we would like a copy, request records make a note in comments & schedule appointment. If never on BC, they can have COPE apt to get started on BC- see COPE instructions above.

9 WH-COLPO WH GYN ProcedurPC See Clinician Guide No No No Must have had Colpo consult visit with one of our clinicians 1st. Any Colpo cancellation required an IM to Beth Hyde for follow-up. In comments specify COLPO(Due to equipment constraints - no more than 2 colpo's per 4/hr. shift - unless extenuating circumstances). Schedule F/U in 2 weeks at the same time the 40 Procedure is scheduled. WH-Diaphragm Fitting PC Visit PC See Clinician Guide Yes No No 20 WH-IUD Insert WH GYN ProcedurPC See Clinician Guide No No No 40 Must have consult before scheduling insert appointment. Schedule appointment after 9:00 to allow for pregnancy lab to be done the morning of visit. Try to NOT schedule on the 1st day of menses due to cramping. WH-Procedure WH GYN ProcedurPC See Clinician Guide No No No 40 Examples: Endometrial Bx, IUD Removal (20 min.) WH-SYMPTOMS Vaginal discharge, female low abdominal/pelvic pain Wound check Day PC, UC All All Yes* No 20 *RN/ as long as patient has been evaluated by SHC clinician Worker's Comp. UC Same Day UC All No No No 20 Refer to Works Comp. Packet Wrist pain Notes: 1. When making Nurse or AIT apt: Only use drop-down reason code menu for visit type. Other info/comments like type of immunization, etc. should be added in the "additional" field 2. apt can be used for TB placement, Non-acute EKGs, Audiometry, Ear Lavage. There needs to be a clinician order for any procedure scheduled with an. In general, apt should be "clearance" vs. "diagnostic". An example of this would be an EKG for SCUBA clearance vs. to r/o chest pain. 3. Priority follow-up appointments are made only under clinician/manager direction or for general use, 24 hours before appointment time. Please see Appointment Scheduling Guidelines Quick Reference. 4. Rx Refills: If patient is requesting an Rx refill and says they are out of medication, please send the patient to the pharmacy. The pharmacy staff will assess the situation, request refills if appropriate, and may authorize an emergency fill for a limited amount of chronic medication (such as contraceptives and asthma medications). Exceptions include medications that are controlled substances or antibiotics etc., or if we have not seen the patient for this medication. In those cases, the patients are routed to the triage nurse.

10 5. Routine screening physicals, annuals: start with mid-levels. Save MD's for "specialties" 6. Continuity: Try to schedule patients with ongoing medicalconditions with the same clinician Notify STUDENTS Beth Hyde MUST via HAVE IM of all ALREADY ED, Colpo LOGGED Consult & IN Colpo AND Appointment KNOW THEIR Cancellations LOG-IN! IF STUDENTS ARE DOING THEIR INITIAL LOG-IN, THEY WILL NOT BE ABLE TO COMPLETE THE QUESTIONNAIRE, SO IT IS IMPERATIVE THAT YOU ADVISE THEM WHEN KING THE APPOINTMENT TO LOG- ON AND COMPLETE BEFORE THEIR APPOINTMENT.

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