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Women Annual Plan
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Women's Health Plan
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Women Labs
• • •
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Radiology
• • •
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Women Referrals
• • •
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Men's Health Plan
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Men's Health Plan
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Men's Labs
• • •
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Radiology
• • •
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Men's Referrals
• • •
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Hormone Meds
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Medication
• • •
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Male Medication Ancillary
• • •
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Immigration Plan
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Immigration Plan
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Medical Weight Loss Plan
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Medical Weight Loss Plan
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Pharmacotherapy:
• • •
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Medication Side effects:
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Semaglutide
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Semaglutide Instructions
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Semaglutide Dosing Frequency
• • •
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Tirzepatide
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Tirzepatide Dosing
• • •
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Diet Plan
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Specialty Labs
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Gut Health
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Gut Health Labs
• • •
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Sex Hormone/ Cortisol
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Sex Hormone /Cortisol
• • •
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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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Follow Up
• • •
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Pallitive Care Plan
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Palliative Care Plan
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Face Time
• • •
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Informed Consent (IC) Form Signed
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Radiology
• • •
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Referrals Advised
• • •
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Light Exercise/Activity Level Advised
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Therapies/Treatments Advised
• • •
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Labs
• • •
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Pharmacotherapeutics
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Pharmacotherapeutics Comments
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Pain Management Contract Signed
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Opioids Prescribed
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Maintain Opioid Medication
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Increase Opioid Medication
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Non Opioid SIG
• • •
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Short Acting Opioids
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Short Acting Opioid SIG
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Long Acting Opioid SIG
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Treat and Goals
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Violated Narcotic Agreement(Discharge)
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Discharge
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General Instructions
• • •
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Follow Up?
• • •
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