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Procedure performed by clinician
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Performed by tech, supervised by clinician
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Performed by MA, supervised by clinician
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Name of Procedure***
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Verbal Consent Given
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Indication:
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Anesthesia/Sedation.: ***
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Preparation
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Description of Material Removed:
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Technique:
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Notes:
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Post Procedure Exam:
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Pt tolerated procedure well. No complications
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Discussed f/u instructions and wound care
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Photo
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Photo
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