COMPLETE HISTORY CHECKLIST
( Social/Cultural History ( Other _____ Key Feedback Points: _____ _____ _____ _____ _____ _____ Adapted from L Lane, MD and R Gottlieb, MD, Jefferson Medical College. By E Hamburger, MD, S Cuzzi, MD and D Coddington, MD, Children’s National Medical Center. Structured Clinical Observation Skills Checklist. Please place a check by each item below to indicate behaviors that were observed (Y ... ................
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