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[DOC File]LEAVE REQUEST FORM/AUTHORIZATION - United States Navy
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navcompt form 3065 (3pt) (rev. 2-83) 1. date of request. 2. for . admin. use only. approval of this leave is . not valid . without control no,

[PDF File]Oswestry Low Back Disability Questionnaire
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The patient can cope with most living activities. Usually no treatment is indicated apart from advice on lifting sitting and exercise.

[PDF File]VAMC SLUMS Examination - Saint Louis University
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SH Tariq, N Tumosa, JT Chibnall, HM Perry III, and JE Morley. The Saint Louis University Mental Status (SLUMS) Examination for Detecting Mild Cognitive Impairment and Dementia is more sensitive than the Mini-Mental Status Examination (MMSE) - A pilot study. J am Geriatri Psych ( in press). 2 3 Questions about this assessment tool? E-mail aging ...

[PDF File]International Prostate Symptom Score (I-PSS)
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global impact of benign prostatic hyperplasia (BPH) Symptoms or quality of life, it may serve as a valuable starting point for a doctor-patient conversation. The SCI has agreed to use the symptom index for BPH, which has been developed by the AUA Measurement Committee, as the official worldwide symptoms assessment tool for patients

[PDF File]TINETTI BALANCE ASSESSMENT TOOL
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TINETTI BALANCE ASSESSMENT TOOL GAIT SECTION Patient stands with therapist, walks across room (+/- aids), first at usual pace, then at rapid pace. Risk Indicators: Tinetti Tool Score Risk of Falls ≤18 High 19-23 Moderate ≥24 Low Date Indication of gait (Immediately after told to ‘go’.) Any hesitancy or multiple attempts = 0 No hesitancy = 1

[PDF File]Form Refund Due a Deceased Taxpayer
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Form 1310 (Rev. 8-2014) Page . 2 Additional Information For more details, see Death of a Taxpayer in the General Instructions section of the Form 1040, Form 1040A, or Form

[PDF File]VISA MERCHANT CATEGORY CLASSIFICATION (MCC) CODES DIRECTORY
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3009 air canada 3010 klm (royal dutch airlines) 3011 aeorflot 3012 quantas 3013 alitalia 3014 saudia arabian airlines 3015 swissair 3016 sas 3017 south african airways 3018 varig (brazil) 3020 air-india 3021 air algerie 3022 philippine airlines 3023 mexicana 3024 pakistan international 3025 air new zealand 3027 uta/interair

[PDF File]Clinical Opiate Withdrawl Scale - National Institute on Drug ...
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Clinical Opiate Withdrawal Scale Introduction The Clinical Opiate Withdrawal Scale (COWS) is an 11-item scale designed to be administered by a clinician. This tool can be used in both inpatient and outpatient settings to reproducibly rate common signs and symptoms of opiate withdrawal and monitor these symptoms over time. The summed

[PDF File]The Mood Disorder Questionnaire (MDQ) - Overview
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The Mood Disorder Questionnaire (MDQ) - Overview The Mood Disorder Questionnaire (MDQ) was developed by a team of psychiatrists, researchers and consumer advocates to address the need for timely and accurate evaluation

[PDF File]Form W-9 (Rev. October 2018)
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Form W-9 (Rev. 10-2018) Page . 2 By signing the filled-out form, you: 1. Certify that the TIN you are giving is correct (or you are waiting for a

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