Series Title (Agency Series #): Description, Retention (Legal Citation)
Encounter Records (DOH13-002): Documents client information and services from field teams for entry into the electronic medical records system. Includes encounter forms indicating client demographic information, and check-off boxes for data entry indicating services provided during the particular visit.
Retention: Retain until entered and verified in system. (2009-0001/001)
Health Service Records: Field Teams (DOH13-003): Records documenting field services provided to clients. Services may include physicals, management of acute illness and injury, immunizations, family planning and reproductive health care, health education and promotion activities, and mental health services. Records may include correspondence; reports; professional notations; laboratory reports; treatment and x-ray authorizations; release of information; clinical or medical records including client identification, progress notes, and records of visits; a history of previous service; referrals; testing and evaluation reports; treatment plans; progress notes; enrollment, fee, and billing records; legal records; permission to treat; medical assessment including laboratory and other tests, emergency room services, and medication and prescription records; reports; and other related data. Access to these records may be exempt from disclosure by ORS 179.505; ORS 192.502(2).
Retention: Retain 6 years after last service date. (MOAR 166-150-0065(20))