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Labs
• • •
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Lab Comments
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Radiology
• • •
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Radiology Comments
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PT Recommendations
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PT Recommendation Comments
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Home exercise handout
• • •
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Procedure
• • •
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Procedure comments
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Opioid pain medication management:
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Treatment goals
• • •
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Opioid dosing guidelines statement
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Oral drug screen (Oral-Eze)
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UDS Comment
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CURES review
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CURES Comment
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ORT
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ORT score
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Opioid pain management
• • •
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Risk factors for opioid overdose
• • •
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Mitigation measures
• • •
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Medication dose and frequency
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Nonopioid pharmacologic therapy: See medication list
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Home health comments
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Referrals
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Referral Comments
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Education
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Education Comments
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Diet
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Diet Comments
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General Instructions
• • •
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General Instruction Comments
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DME
• • •
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DME Prescription
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DME release signature
• • •
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Follow up
• • •
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