This is how you become wise. I know nothing of surgery

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We are both saying the same thing. Yes, you definitely want the file in the chart, but it has to get there somehow. And, this shouldn't be something you waste your time on from the room. Nor do you want to pick and choose who needs a flow sheet. Rather, you want a system.
So, after you design a flow sheet via Excel that you want to use, you save it several places. Burn one to a CD, etc. So, you always have the "template." It is best that your receptionist have a copy of this template on her desktop. This way every time a patient (not necessarily new to the practice) but someone without a flow sheet in their chart, she would open the chart, go to Imported Items, and import the sheet. It is probably easiest to fill in the demographics of the patient in the Excel sheet after it has been imported as this will lessen the chance of saving the Excel sheet back to the desktop with all of the info in it. This would be no big deal as you would just go in and delete the information and re-save it.
Hope this is clearer.