RRafaPolyclinic
Document Templates & Supplies

Rafa Clinical Workspace

28 standardized Saudi healthcare document templates with digital signing, plus clinical supplies for Rafa Polyclinic.

28 templates · MOH · CBAHI · SFDA · NPHIES compliant
Consent Forms
General Consent for Treatment

Standard informed consent covering examinations, tests, and nursing care.

FREE
Consent Forms
Surgical Consent

Detailed consent for surgery including risks, alternatives, and possible extensions.

FREE
Consent Forms
Anesthesia Consent

Consent for general or local anesthesia with risk disclosure.

FREE
Consent Forms
Blood Transfusion Consent

Consent for blood or component transfusion.

FREE
Consent Forms
Guardian Consent for Minor

Parental consent for medical treatment of a minor.

FREE
Consent Forms
Clinical Trial Consent

IRB-approved consent for clinical research.

FREE
Consent Forms
AMA Discharge Form

Legal waiver for leaving against medical advice.

FREE
Consent Forms
Contrast Imaging Consent

Consent for contrast-enhanced imaging with allergy screening.

FREE
Consent Forms
Endoscopy Consent

Consent for endoscopic procedures with biopsy and sedation risks.

FREE
Consent Forms
Sterilization Consent

Consent for permanent sterilization acknowledging irreversibility.

FREE
Consent Forms
Mental Health Consent

Consent for psychiatric treatment including medication and ECT.

FREE
Consent Forms
Vaccination Consent

Standard consent for vaccine administration.

FREE
Consent Forms
DNR Order Document

Ethical and legal DNR order documentation.

FREE
Clinical Forms
Patient Admission — EHR Form

Standard intake form: demographics, history, allergies, chief complaint.

FREE
Clinical Forms
Medical Prescription Form

SFDA-compliant prescription template.

FREE
Clinical Forms
Medical Referral Form

Patient referral between facilities or departments.

FREE
Clinical Forms
Discharge Summary

Comprehensive discharge summary with follow-up plan.

FREE
Clinical Forms
Clinical Incident Report

CBAHI-compliant patient safety incident form.

FREE
Admin Forms
Employee File Cover

Complete employee file with credentials, licensing, evaluations.

FREE
Admin Forms
SOP Template

Standard operating procedure template with scope and steps.

FREE
Admin Forms
Committee Minutes Form

Meeting minutes with decisions and corrective actions.

FREE
Admin Forms
Clinical Privileging Form

Credentialing form for clinical staff scope of practice.

FREE
Financial Forms
Medical Invoice

Standard invoice with CPT codes and itemized charges.

FREE
Financial Forms
Insurance Claim (NPHIES)

NPHIES-compliant insurance claim with ICD-10 and CPT.

FREE
Financial Forms
Medical Fee Schedule

Fee schedule with approved and insurance pricing.

FREE
Legal Forms
Facility License Application

MOH license application with required attachments.

FREE
Legal Forms
PDPL Data Processing Consent

SDAIA-compliant consent for health data processing under PDPL.

FREE
Legal Forms
Disease Report Form

Epidemiological surveillance report for notifiable diseases.

FREE
Clinical Supplies
Dual-Head Stethoscope — Cardiology Grade

Premium acoustic stethoscope with dual-head chestpiece.

275 SAR
Clinical Supplies
LED Otoscope — Diagnostic Set

Rechargeable LED otoscope with specula set.

410 SAR
Clinical Supplies
Neurological Reflex Hammer

Precision reflex hammer for neurological examinations.

65 SAR
Clinical Supplies
Fingertip Pulse Oximeter

Fast SpO2 and pulse readings with OLED display.

145 SAR
Diagnostic
ECG Recording Paper — 50mm x 20m

High-quality grid paper for 12-lead ECG machines.

95 SAR
Diagnostic
Ultrasound Gel — 250ml

Hypoallergenic water-based gel for clear imaging.

38 SAR
PPE
Surgical Face Masks — 50 Pack

3-ply disposable masks with high bacterial filtration.

45 SAR
PPE
Nitrile Gloves — 100 Pack

Powder-free, latex-free gloves for clinical safety.

62 SAR
PPE
Isolation Gown — 10 Pack

Fluid-resistant gowns for infection control.

125 SAR
Cart
Cart is empty

Browse supplies and add items.

Book with Danah