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Assessments / Injections / Procedures
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Problem List
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INJECTIONS
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B-12 1000mcg
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Medication Supplied by Patient-YES
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NDC #:
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Lot #:
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Expiration Date:
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Site
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Given By
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Reaction
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Testosterone 200 mg/1 mL
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Medication Supplied by Patient-YES
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NDC #:
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Lot #:
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Expiration Date:
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Site
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Given By
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Reaction
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Decadron 0.5mL (2mg)
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Decadron 1mL (4mg)
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Decadron 1.5 mL (6mg)
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Decadron 2mL (8mg)
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NDC #:
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Lot #:
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Expiration Date:
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Site
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Given By
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Reaction
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NDC #:
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Lot #:
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Expiration Date:
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Site
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Given By
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Reaction
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NDC #:
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Lot #:
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Expiration Date:
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Site
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Given By
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Reaction
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NDC #:
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Lot #:
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Expiration Date:
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Site
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Given By
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Reaction
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ASSESSMENTS
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Assessments
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PHQ-9 Assessment
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PHQ-9 Screening
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GAD-7
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GAD-7 Screening
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Urinary Incontinence Screening
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New Field
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Urinalysis Results
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Leukocytes
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Nitrite
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Urobilinogen
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Protein
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pH
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Blood
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Specific Gravity
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Ketone
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Bilirubin
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Glucose
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Blood Glucose Reading
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Blood Glucose
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Blood Pressure Monitoring
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Reassessed BP
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BP Site/Characteristics
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Reassessed BP
/
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BP Site/Characteristics
• • •
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Reassessed BP
/
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BP Site/Characteristics
• • •
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