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CHIEF COMPLAINT
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Any relapse since last visit?
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Any cravings since last visit?
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Kasper/PDMP shows compliance?
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Pt has been actively participating in counseling?
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Pt wishes to proceed with tapering dose at this time?
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Previous UDS was positive for:
• • •
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UDS confirmation
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Confirmed relapse addressed by:
• • •
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PHYSICAL EXAMINATION
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HEENT
• • •
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CHEST EXAMINATION
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SKIN
• • •
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ABDOMINAL EXAM
• • •
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EXTREMITIES
• • •
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NEUROLOGICAL EXAM
• • •
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PSYCHIATRIC EXAMINATION
• • •
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LABS
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UDS witnessed
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Serum obtained for labs
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