U.S. Department of Health and Human Services
Indian Health Service: The Federal Health Program for American Indians and Alaska Natives
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Electronic Health Record (EHR)  

CHA/P TIU Templates

SPECIAL INSTRUCTIONS: To properly view the templates, first import the template files into EHR at your site. To download files for importing into EHR, right-click on each link and choose "Save Target As…" and then import the templates into EHR to view them.

TIU Templates are .TXML files!

The following TIU Templates correspond to the CHAM:

  • CHAP History General Template refers to the CHAM Inside Front Cover
  • CHAP Exam General Template refers to the CHAM Adult Screening Physical Exam (R-204)
  • CHAP History Respiratory Illness Template refers to the CHAM Respiratory Illness (p. 290)
  • CHAP Exam Respiratory Template refers to the CHAM Respiratory Illness (p. 291-292)
  • CHAP History Ear Problem Template refers to the CHAM Ear Problems (p. 235)
  • CHAP Exam Ear Problem Template refers to the CHAM Ear Problems (p. 236)
  • CHAP History Young Child Who May Be Sick Template refers to the CHAM Young Child Who May Be Sick (p. 145-146)
  • CHAP Sick Child Screening Exam Template refers to the CHAM Sick Child Screening Exam (p. 147)
  • CHAP PEF Lab-Assessment-Plan Template refers to the CHAM from Patient Encounter Form (PEF)

First, the CHA/P will use the "History General" Template. Depending on the findings, a specific history template, such as Respiratory can be used. If the diagnosis is obvious, the CHA/P can use a specific history template.

Next, the CHA/P will use the appropriate Exam template.

CHA/Ps may use multiple templates per encounter. Directions are included at the bottom of each Template.

Access the TIU Templates on the EHR FTP site.

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