Templates › Forms › SEO page

Run: Skin Integrity Admission Assessment

Use this Skin Integrity Admission Assessment to document baseline skin condition, existing wounds, and Braden risk within 24 hours of admission. It helps car...

Fill this out, get a PDF emailed to you. No account required. Want to run it with your team and track results? Sign up free →

Assessment Overview

Patient Identifier (required)

Enter the facility medical record number or other internal identifier. Do not enter SSN.

Admission Date (required)

Assessment Date (required)

Assessment Time (required)

Assessor Name (required)

Completed within 24 hours of admission? (required)

Baseline Skin Findings

Is the skin intact overall? (required)

Baseline Skin Condition Notes

Briefly describe any notable findings such as dryness, redness, edema, bruising, scars, rash, or pressure-related changes.

Are there any existing wounds, bruising, scars, or other skin concerns? (required)

Type of Existing Finding (required)

Location Summary (required)

List the body location(s) for each finding, using clear anatomical terms.

Detailed Wound Documentation

Number of Wounds Requiring Detailed Documentation (required)

Wound Details (required)

Braden Risk Screening

Braden Score (required)

Enter the total Braden score from the facility-approved screening tool.

Pressure Injury Risk Level (required)

Contributing Risk Factors

Care Plan Actions

Preventive Measures Initiated (required)

Specialty Consult Requested? (required)

Consult Type (required)

Follow-up Notes

Include any escalation, patient education, or reassessment plan.

Consent and Submission

I understand this form collects limited clinical PII for treatment and care planning. (required)

Yes No N/A

What happens after I submit

After submission, the assessment will be saved to the patient record, routed to the care team for review, and used to support preventive skin care planning and audit trail documentation.

Get your results

Enter your email — we'll send you a PDF of your filled-out template, plus the occasional MangoScoop newsletter (templates, workflow tips, product updates). Unsubscribe anytime — link is in every email.

Email (required)

Your name (optional)

Generated with MangoApps Templates — browse 250+ free