FPRHU FY13-14 Record Audit - Male Tool
Health Department: _____________________________________________ Date: _____________
Reviewers: _______________________________________________________________________
Please note, red font indicates new language. Items that are stricken through no longer apply.
If your agency sees male clients, please review at least one preventive visit and one problem visit. For the problem visit, use Table 10.
| |Patient Identifier |
| |
|2. Labs |
3. Physical Assessment 1 2 3 4 5 6 7 8 9 10
|Height R |
|5. Client Education |
|Client education must be documented in the record and must provide clients with info needed to: |
| |
|6. Client Method Counseling |
|7. Consent Form for Method Selected |
| |
|9. Provider Qualifications** |
| |
| |
10. Problem Visit (Use this section only to monitor a problem visit chart)
| |
-----------------------
CODE
( = Present
0 = Absent
KEY
(R) Required to recommend/offer
(I) As indicated by history, physical, method, or previous lab test
NA = Not Applicable
................
................
In order to avoid copyright disputes, this page is only a partial summary.
To fulfill the demand for quickly locating and searching documents.
It is intelligent file search solution for home and business.
Related searches
- dod 7000.14 r vol 12 ch 7
- dod fmr 7000.14 r vol 8
- small company audit exemption
- minecraft 1.14 all crafting recipes
- 1.14 crafting recipe list
- all minecraft 1.14 crafting recipes
- dod 7000.14 r volume 2a
- dod 7000.14 r volume 7a 2018
- uk audit exemption
- dod 7000.14 r 2019
- dod 7000.14 r volume 9
- minecraft 1.14 crafting recipes list