|
consent
|
|
|
wound #
|
wound measurements starting CAMP/CTP
|
|
wound location
|
4 week measurements
|
|
Date and time applied
|
current wound measurements
|
|
A1C if indicated and date
|
ABI if indicated and date
|
|
smoking status
|
|
|
Time out
|
Brand
|
|
Type
|
size
|
|
Lot #
|
Expiration Date
|
|
Units Applied
|
Product Code
|
|
Wastage
|
CAMP/CPT dressing
|
|
|
|
|
|
wound #
|
|
wound measurements starting CAMP/CTP
|
wound location
|
|
4 week measurements
|
Date and time applied
|
|
current wound measurements
|
|
|
Time out
|
Brand
|
|
Type
|
size
|
|
Lot #
|
Expiration Date
|
|
Units Applied
|
Product Code
|
|
Wastage
|
|
|
|
|
|
|
wound #
|
|
wound measurements starting CAMP/CTP
|
wound location
|
|
4 week measurements
|
Date and time applied
|
|
current wound measurements
|
|
|
|
|
|
Time out
|
Brand
|
|
Type
|
size
|
|
Lot #
|
Expiration Date
|
|
Units Applied
|
Product Code
|
|
Wastage
|
CAMP/CPT dressing
|
|
wound #
|
wound measurements starting CAMP/CTP
|
|
wound location
|
4 week measurements
|
|
Date and time applied
|
current wound measurements
|
|
Time out
|
Brand
|
|
Type
|
size
|
|
Lot #
|
Expiration Date
|
|
Units Applied
|
Product Code
|
|
Wastage
|
|
