Weight loss medications prescription list
[DOC File]Dear Patient:
https://info.5y1.org/weight-loss-medications-prescription-list_1_895f59.html
List the diets/programs have you tried within the last 5 years: Diet or Weight Loss Medication Year Length in Months Number of Pounds Lost What age were you considered obese? What was your lowest adult weight? What is your desired weight? Check if you have used the following medications to lose weight: Phentermine. Phen-Fen Orlistat (Xenical)
[DOCX File]Sample Prior-Authorization Request Letter
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There are no prescription weight loss medications on the formulary. An adverse reaction. A drug-drug interaction . A contraindication. A failure of a therapeutic trial: [specify which formulary alternatives/preferred medications have been tried and describe results] _____ Please contact my office should you require any additional information. ...
[DOC File]Answer Guide for Medical Nutrition Therapy: A Case Study ...
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16. Determine Mitch’s initial CHO prescription using his diet history as well as your assessment of his energy requirements. See attached. 17. Identify two initial nutrition goals to assist with weight loss. Carbohydrate controlled diet. Consume carbs consistently throughout the day. 18. Mitch also has hypertension and high cholesterol levels.
[DOCX File]Church Street United Methodist
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It is not approved for weight loss and the manufacturer states there is no evidence that the drug causes weight loss. It is illegal to sell HCG, in any amount, over the counter and the FDA continues to take action against companies engaging in this practice. There are FDA approved prescription drugs to help people with long-term weight management.
[DOC File]Evaluation of Weight Related Medical Conditions
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prescribe weight loss medications if you are taking ADD / Other Stimulant medications. A Lost, stolen, or unfilled (unused) Bariatric Medication Prescription cannot be written before 28-30 days from the original date of the prescription. No paid money for your office visit will be refunded.
[DOCX File]Patient Handouts
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It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital.
[DOCX File]Patient Handouts
https://info.5y1.org/weight-loss-medications-prescription-list_1_ebdac2.html
tell your doctor and pharmacist what prescription and nonprescription medications, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: fluoxetine (Prozac), fluvoxamine (Luvox), guanethidine, insulin medications for weight loss and depression, paroxetine (Paxil), and sertraline ...
[DOC File]NEW PATIENT HEALTH SURVEY
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MEDICATIONS: List all prescription or over-the-counter drugs you are taking _____ ... Significant weight loss. Significant weight gain. Increased body fat. Fluctuations in body temperature . Sensitivity to cold or heat. Hot flashes.
[DOC File]PATIENT HISTORY FORM
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Please list any medications that you are now taking. Include non-prescription medications, such as aspirin, vitamins, glucosamine, laxatives, calcium, etc. ... ( Anemia ( Recent weight loss: how much____ ( Hoarseness ( Bleeding tendency ( Fatigue ( Difficulty in swallowing ( Weakness ( Pain in jaw while chewing SKIN
[DOC File]Answer Guide for Medical Nutrition Therapy: A Case Study ...
https://info.5y1.org/weight-loss-medications-prescription-list_1_19f53e.html
16. Determine Mitch’s initial CHO prescription using his diet history as well as your assessment of his energy requirements. 2170kcalx0.5= 1085/4=271.25/4.5= 60.3. 4 CHO exchanges at breakfast, lunch and dinner. 3 exchanges for 2 snacks. 17. Identify two initial nutrition goals to assist with weight loss.
[DOCX File]Home - Doctors Weight Control
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prescription appetite suppressant (for those who are near their weight loss goals). Natural Maintenance: $129.00 (per Month) Available on a monthly basis and includes the supplements of Rx Plus Program, but without any prescription appetite suppressants. Extra . Li. povite. Injections: $60.00 (4 injections/m. onth) Discounted rate for patients
Oregon Weight Loss Surgery LLC, - Legacy Health
Have you ever taken any of the following weight loss medications? If yes how long? Phen-Phen: _____ months . Meridia: _____ months . Other: _____months Name:_____ Date of Birth:_____ Current Medications: please list all prescription, over the counter medications, vitamins and supplements you are taking. Name of drug Mg Dosage Frequency # Of ...
[DOC File]PATIENT HISTORY FORM - Hopkins Medicine
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Please list any medications that you are now taking. Include non-prescription medications & vitamins or supplements: Name of drug Dose (include strength & number of pills per day) How long have you been taking this? ... ( Recent weight loss: how much____ ( Dizziness ( Excessive worries ( Fatigue ( Fainting or loss of consciousness ( Difficulty ...
[DOCX File]Please list ALL medications (including prescription, over ...
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Patient Medication List. Please list ALL medications (including prescription, over –the-counter, vitamins, dietary or nutritional supplements) which you may be taking routinely and/or on an as needed basis.
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