Medicare annual wellness exam form pdf
[DOC File]American College of Physicians | Internal Medicine | ACP
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(Enter date of procedure/exam) Women. Breast Exam Mammogram Breast Self Exam Education PAP Men Testicular Self Exam Education DRE PSA Geriatric Mini-Mental Status Exam Functional Assessment Advance Directives General Flex Sig/Colon Stool for Occult Blood Dental Exam Dilated Eye Exam Diabetic Foot Exam ...
[DOC File]Instructions for Completing the Well Child Care Record ...
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All components of the physical exam must be documented for this item to be considered met. If a sick visit (E/M) is completed and billed on the same day as the well/preventative visit, the separate note for the sick visit must clearly document an appropriate physical exam for the level billed for that visit.
[DOC File]SAMPLE SCRIPT FOR OPENING AND CLOSING YOUR …
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Here is a sample script for use in planning your opening remarks: “Good evening! My name is (name) and this is (name) , (name) , (name) , and (name) .
[DOC File]Optional Long Term Care Assessment and Care Planning Tool
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This form was created by a group of Adult Family Home providers, resident advocates, Washington State DSHS/Aging and Adult Services Administration staff and professional assessors, and was designed to include the elements of an assessment required in WAC 388-76-61020. This is a sample form and not a required form.
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