|
Labs
• • •
|
Lab Comments
|
|
LEU
• • •
|
|
|
NIT
• • •
|
|
|
URO
• • •
|
|
|
PRO
• • •
|
|
|
pH
• • •
|
|
|
BLO
• • •
|
|
|
SG
• • •
|
|
|
KET
• • •
|
|
|
BIL
• • •
|
|
|
GLU
• • •
|
|
|
COLOR
• • •
|
|
|
Lab Comments
|
|
|
|
|
|
10 year ASCVD risk
|
|
|
>40yo,>/5%
|
>40yo, 10-20%
|
|
Occupational Stress Awareness Consultation
|
|
|
Breast cancer screen
|
|
|
Cervical Cancer Screen
|
|
|
Prostate ca screen
|
|
|
Colon ca screen
|
|
|
Lung Cancer Screen
|
|
|
Skin Cancer Screening
|
|
|
Sleep Disturbance Screen
|
|
|
Cancer and CVD risk and reduction
|
|
|
Testosterone
|
|
|
Birth control
|
|
|
HRT
|
|
|
Comment
|
|
|
FIRE Plan
|
|
|
anticoagulation/prolong PT/INR
|
Med comment
|
|
Opiods
|
Med comment
|
|
muscle relaxant
|
Med comment
|
|
Sedatives incl benzo, dronabinol, marijuana
|
Med comment
|
|
neuroleptic
|
Med comment
|
|
antihypertensive
|
Med comment
|
|
inhaled bronchodilator
|
Med comment
|
|
high-dose steroid for chronic disease
|
Med comment
|
|
methotrexate/cellcept/cytoxan,tnf-alpha blocker
|
Med comment
|
|
anabolic steroid
|
Med comment
|
|
OSHA Respiratory decision
• • •
|
|
|
Clearance decision
• • •
|
Clearance comment
|
|
|
|
|
Body Diagram (female)
|
Body Diagram (male)
|
|
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
|
