|
Mammogram
|
|
|
Colonoscopy
|
|
|
Pap smear
|
|
|
Dexa scan
|
|
|
Nicotine screeening
|
Comments:
|
|
Nutrition and Dietary Restrictions
• • •
|
|
|
Labs
• • •
|
Lab Comments
|
|
Radiology
• • •
|
Radiology Comments
|
|
PT Recommendations
|
PT Recommendation Comments
|
|
Home Health
• • •
|
Home health comments
|
|
Referrals
|
Referral Comments
|
|
Education
|
Education Comments
|
|
Diet
|
Diet Comments
|
|
General Instructions
• • •
|
General Instruction Comments
|
|
|
|
|
General Counselling:
|
General
• • •
|
|
Nutrition and Dietary Restrictions
|
|
|
Well balanced diet
|
Low cholesterol, low fat diet
|
|
Diabetic diet
|
DASH diet
|
|
High fiber diet
|
Low sodium diet
|
|
Potassium
|
Caffeine
|
|
Fitness/Exercise
|
|
|
General Fitness Program
|
Cardiovascular Conditioning
|
|
Strength Training
|
Balance and Core Strength
|
|
Flexibility
|
Rehabilitation Exercises
|
|
Kegel Exercises
|
Eppley Maneuvers
|
|
Weight Management
|
|
|
Optimal Healthy Weight
|
BMI and Weight
|
|
Basic Weight Loss Advice
|
Advanced Weight Loss Advice
|
|
Behavioral Health
|
|
|
Adequte Sleep, Sleep Hygiene
|
Caregiver Stress
|
|
Managing Stress
|
Mindfulness
|
|
Formal Counseling
|
|
|
Sexuality and Relational Issues
|
|
|
Relationships
|
Sexual Dysfunction/Intimacy Issues
|
|
Contraception
|
STI Prevention
|
|
Abusive Relationships
|
|
|
Substance Abuse
|
|
|
Address Substance Abuse/Addiction
|
Steroid Use
|
|
Options for Referral to Specialists
|
|
|
Smoking Cessation
|
|
|
Basic Smoking Cessation
|
Advanced Smoking Cessation
|
|
Congratulated on cessation
|
|
|
Medication Management
|
|
|
Importance of Medication Adherence
|
Adverse Drug Effects
|
|
Injectable Medications
|
Inhaled Medications
|
|
Controlled Substances
|
Controlled Substance Contract
|
|
Generic Substitution
|
Medications from Foreign/Internet Suppliers
|
|
Other Self Care Issues
• • •
|
Injury Prevention/Avoidance
• • •
|
|
Comp. & Alt. Medicine
• • •
|
Comments
|
|
|
|
|
Annual Wellness Counselling
|
|
|
Advanced Directives
|
|
|
Nutrition
|
|
|
Well balanced diet
|
Low cholesterol, low fat diet
|
|
High fiber diet
|
Caffeine
|
|
Fitness/Exercise
|
|
|
General Fitness Program
|
Cardiovascular Conditioning
|
|
Strength Training
|
Balance and Core Strength
|
|
Flexibility
|
|
|
Weight Management
|
|
|
Optimal Healthy Weight
|
BMI and Weight
|
|
Basic Weight Loss Advice
|
Advanced Weight Loss Advice
|
|
Behavioral Health
|
|
|
Adequte Sleep, Sleep Hygiene
|
Managing Stress
|
|
Caregiver Stress
|
Relationships
|
|
Abusive Relationships
|
Mindfulness
|
|
Formal Counseling
|
|
|
Cancer Screening
|
|
|
Colon cancer screening
|
Cervical cancer screening
|
|
Breast cancer screening
|
Breast self-exam
|
|
Prostate cancer screening
|
|
|
Injury Prevention/Avoidance
|
|
|
Seat belts
|
Helmets
|
|
Texting and other vehicle safety
|
Firearm
|
|
Fire Safety
|
|
|
Self-Care Issues
|
|
|
Osteoporosis
|
Sun exposure
|
|
Mosquito exposure
|
Routine wellness visits
|
|
Dental Care
|
Eye Care
|
|
Hearing protection
|
|
|
Geriatric Issues
|
|
|
Hazards in home
|
Driving safety
|
|
Prevention of falls
|
Independence
|
|
Advised cane
|
Advised walker
|
|
Advised not driving.
|
Advised Assisted Living situation
|
|
Comments
|
|
|
|
|
|
Disease Management Counselling
|
|
|
Asthma Management
|
|
|
Review of/managing asthma
|
Peak Flows
|
|
Action plan
|
Smoking cessation
|
|
Patient Education
|
Inhaled Medication
|
|
Importance of medication adherence
|
Adverse drug effects
|
|
Blood Pressure Control
|
|
|
Complications from poor control
|
Dash diet
|
|
Regular physical activity
|
BMI 19-25
|
|
Moderation of alcohol consumption.
|
Smoking cessation
|
|
Importance of medication adherence
|
Adverse drug effects
|
|
Home Monitoring
|
|
|
Cholesterol/Lipid Control
|
|
|
Complications if control not achieved
|
Lipid goals
|
|
Diet for high cholesterol
|
Diet for high triglycerides
|
|
BMI 19-25
|
Smoking cessation
|
|
Importance of medication adherence
|
Adverse drug effects
|
|
Coronary Artery Disease Mgmt
|
|
|
Complications if control not achieved
|
Risk factor modification
|
|
Regular physical activity
|
BMI 19-25
|
|
Smoking cessation
|
Daily Aspirin
|
|
Management of angina
|
Patient education
|
|
Importance of medication adherence
|
Adverse drug effects
|
|
Congestive Heart Failure Mgmt.
|
|
|
Complications if control not achieved
|
CAD risk factor modification
|
|
Regular physical activity
|
Low sodium diet
|
|
Daily weights
|
Disease progression
|
|
Patient education
|
Importance of medication adherence
|
|
Adverse drug effects
|
|
|
COPD Management
|
|
|
Review of/Managing COPD
|
Smoking cessation
|
|
Patient education
|
Inhaled Medication
|
|
Importance of medication adherence
|
Adverse drug effects
|
|
Diabetes Management
|
|
|
Home glucose monitoring
|
Hypoglycemia
|
|
Diabetic diet
|
Cardiovascular conditioning
|
|
BMI and weight
|
Basic weight loss advice
|
|
Advanced weight loss advice
|
BP and cholesterol control
|
|
Basic smoking cessation
|
Advanced smoking cessation
|
|
Daily Aspirin
|
Annual eye exam
|
|
Routine dental screening
|
Vaccinations
|
|
Injectable medications
|
|
|
Depression Management
|
|
|
Review of/managing depression
|
Adequate sleep, sleep hygiene
|
|
Managing stress
|
Formal counseling
|
|
Avoidance of alcohol consumption
|
Suicidal thinking
|
|
Importance of medication adherence
|
Adverse drug effects
|
|
Controlled substances
|
Patient education
|
|
GI Symptom Treatment
|
|
|
Avoid dairy
|
Bowel regimen plan
|
|
BRAT diet
|
Diet modifications
|
|
Enema
|
Fiber
|
|
GERD diet
|
Imodium
|
|
Milk-of-Magnesia
|
Other lifestyle modifications
|
|
OTC H2-Blocker
|
OTC PPI
|
|
Patient education
|
Stool softener
|
|
Stimulant Laxative
|
Tums
|
|
General Symptom Treatment
|
|
|
Adequate fluids
|
Increased fluids
|
|
Fever education
|
Tylenol
|
|
OTC NSAIDs
|
Rest
|
|
Injury Management
|
|
|
PRICE
|
Active Rest
|
|
Brace/splint
|
Wound care
|
|
Use of heat/cold
|
Crutches
|
|
Cane
|
Walker
|
|
Rehabilitation Exercises
|
Physical Therapy
|
|
Therapeutic Massage
|
|
|
Skin/Topical Care and Management
|
|
|
Skin hygiene
|
Moisturizing
|
|
Corticosteroids
|
Acne care
|
|
MRSA precautions
|
Insect Infestation Counseling
|
|
Eye Care
|
No Q-tips
|
|
No water in ears
|
Soften wax
|
|
Restrictions
|
|
|
No weight-bearing
|
Lifting restriction
• • •
|
|
Work absence
|
|
|
Work caution
|
Sports absence
|
|
School absence
|
|
|
Practice Restriction
|
Contact Restriction
|
|
URI/Allergy Symptom Treatment
|
|
|
Congestion care
|
Nasal irrigation
|
|
Self-insuflation
|
Sore throat care
|
|
OTC Sudafed
|
OTC Afrin
|
|
OTC multi-symptom preps
|
OTC anti-tussives
|
|
OTC non-sedating antihistamines
|
Home remedy
• • •
|
|
Comments
|
|
|
|
|
|
Call 911
|
Comments
|
|
Call 911 - High Fever
|
Comments
|
|
Call 911 - Come to Office
|
Comments
|
