| 
               Post Op OD 
  
  
  • • •
  
 | 
          
            
               Post Op OS 
  
  
  • • •
  
 | 
          
          
| 
               Injection OD 
  
  
  • • •
  
 | 
          
            
               Injection OS 
  
  
  • • •
  
 | 
          
          
| 
               Surgery OD 
  
  
  • • •
  
 | 
          
            
               Surgery OS 
  
  
  • • •
  
 | 
          
          
| 
               Laser OD 
  
  
  • • •
  
 | 
          
            
               Laser OS 
  
  
  • • •
  
 | 
          
          
| 
               Drops OD 
  
  
  • • •
  
 | 
          
            
               Drops OS 
  
  
  • • •
  
 | 
          
          
| 
               | 
          
            
               | 
          
          
| 
               Systemic Medications 
  
  
  • • •
  
 | 
          
            
               Referrals 
  
  
  • • •
  
 | 
          
          
| 
               Referral Free Text 
  
  
  
  
 | 
          
            
               | 
          
          
| 
               Imaging 
  
  
  • • •
  
 | 
          
            
               Recommendations 
  
  
  • • •
  
 | 
          
          
| 
               Education 
  
  
  • • •
  
 | 
          
            
               AREDS Advice 
  
  
  
  
 | 
          
          
| 
               POAG Plan of Care? 
  
  
  
  
 | 
          
            
               Driving Instructions 
  
  
  • • •
  
 | 
          
          
| 
               Positioning 
  
  
  • • •
  
 | 
          
            
               Travel Instructions 
  
  
  • • •
  
 | 
          
          
| 
               Follow up 
  
  
  • • •
  
 | 
          
            
               Imaging Next Visit 
  
  
  • • •
  
 | 
          
          
| 
               Dilation 
  
  
  • • •
  
 | 
          
            
               | 
          
          
| 
               Consider 
  
  
  • • •
  
 | 
          
            
               Procedure visit 
  
  
  • • •
  
 | 
          
          
| 
               Schedule 
  
  
  • • •
  
 | 
          
            
               Allergy Instructions 
  
  
  • • •
  
 | 
          
          
| 
               Labs 
  
  
  • • •
  
 | 
          
            
               Radiology 
  
  
  • • •
  
 | 
          
          
| 
               Time 
  
  
  
  
 | 
          
            
               Emergency 
  
  
  • • •
  
 | 
          
          
| 
               Obtain Prior Records 
  
  
  
  
 | 
          
            
               Note sent to PCP 
  
  
  
  
 | 
          
          
| 
               DR + 
  
  
  
  
 | 
          
            
               No DR 
  
  
  
  
 | 
          
          
| 
               Discussion with MD 
  
  
  
  
 | 
          
            
               | 
          
          
| 
               | 
          
            
               | 
          
          
| 
               No Dilation/Established 
  
  
  
  
 | 
          
            
               | 
          
          
| 
               Dilation/Est/Low MDM 
  
  
  
  
 | 
          
            
               Dilation/New/Low MDM 
  
  
  
  
 | 
          
          
| 
               Dilation/Est/Minor Surgery/Meds 
  
  
  
  
 | 
          
            
               Dilation/New/Minor Surgery/Meds 
  
  
  
  
 | 
          
          
| 
               Dilation/Est/Major Surgery 
  
  
  
  
 | 
          
            
               Dilation/New/Major Surgery 
  
  
  
  
 | 
          
          
