Pekingese Breed Death Report
|
|
|
- Leon Glenn
- 3 years ago
- Views:
Transcription
1 Report from the Kennel Club/ British Small Animal Veterinary Association Scientific Committee Summary results of the Purebred Dog Health Survey for the Pekingese breed Warning: The results of this survey and particularly the breed-specific analyses should be interpreted with caution. The overall response rate was only 24% with breed-specific response rates from 4.% to 64.7%.
2 The Pekingese breed A total of 174 forms were sent out and 33 were returned, representing 174 live dogs. This breed had a 19.% response rate (33/174) and it represented.24% of all returns (33/13,741). Mortality data A total of 87 deaths were reported and this represents.% of all deaths reported in the survey (87/1,881). The median age at death for the Pekingese breed was 11 years and months (min = 1 year, max = 18 years and 2 months) and this was higher than the overall median of 11 years and 3 months (Figure 1). Table 1 shows the causes of death for the Pekingese breed. Age at death is presented for the most common causes of death (Figure 2). Table 1. Causes of death by organ system/category for the Pekingese breed. Cause of death N % Most common specific causes in descending order 1 Cardiac Heart failure; cardiomegaly; attack; heart disease unspecified 2 Old age Old age 3 Neurologic Spinal disease unspecified; seizures; IVDD 4 Cancer 7 8. Type unspecified (lung, stomach) Perioperative Combinations Ocular Blindness 8 Reproductive Pyometra; testicular torsion 9 Died Infection Kennel cough 11 Other Uncodeable 12 Respiratory Respiratory disease unspecified; respiratory failure 13 Unknown Urologic Kidney failure; bladder stones; cystitis 1 Dermatologic Chronic skin infections 16 Gastrointestinal Intestinal perforation 17 Immune mediated Thrombocytopaenia 18 Sudden death Total 87.
3 Histogram breed: Pekingese 12.. Frequency Mean =.171 Std. Dev. = N = Age_at_death Figure 1. Histogram showing the frequency (as number of dogs) of age at death (in years) for the 87 Pekingese deaths with age at death reported. breed: Pekingese 2 1 Age_at_death cardiac old age neurolog cancer perioper combinat ocular the rest Cause_of_death Figure 2. Box and whisker plot of age at death in years for the most common causes of death in the Pekingese breed (N=87). The dashed line ( ) is the overall median age at death for all dogs in the survey and the dotted line (----) is the overall median age of death for the Pekingese breed. The solid line within each grey box represents the median age at death from the condition. 3
4 Morbidity data The median current age of the 174 live dogs with a reported age was years (min=2 months, max=16 years and 2 months, Figure 3). Health information was reported for 174 live dogs of which 9 (63%) were healthy and 6 (37%) had at least one reported health condition, resulting in a total of 8 reported conditions with a median of 1 condition/dog (min=1, max=8). The median current age of all healthy dogs with a reported age (N=9) was 3 years and 9 months (min=2 months, max=16 years and 2 months). The distribution of gender and neuter status is shown in Table 2. The median current age of all dogs with one or more disease conditions and a reported age (N=62) was 6 years and 8 months (min=1 year and 1 month, max=1 years and 7 months). The median age at diagnosis for all disease occurrences with a reported age at diagnosis (N=3) was 3 years and 6 months (min= 3 months, max= 14 years and 1 month, Figure 4). Table 3 shows the disease conditions for the Pekingese breed. Age at diagnosis is presented for the most common disease conditions (Figure ). Table 2. Distribution of gender and neuter status for 174 the Pekingese breed with reported gender and neuter status. Neuter status Gender Intact Neutered Totals Female (66%) Male 6 (34%) Totals 1 (86%) 24 (14%) 174 (%) There was no association between gender and neuter status (P=.1297). Histogram 2 BREED: Pekingese 1 Frequency Curr_Age 1 2 Mean =.91 Std. Dev. =4.317 N =174 Figure 3. Histogram showing frequency of current age in years for the 174 live the Pekingese breed with age reported. 4
5 Histogram breed: Pekingese Frequency Age_at_diagnosis Mean =4.478 Std. Dev. = N =62 Figure 4. Histogram showing frequency of age at diagnosis for the 62 Pekingese breed with one or more disease conditions, using the youngest age at which a disease condition was first reported for those dogs with more than one disease condition or episode.
6 breed: Pekingese Age_at_diagnosis reproduc neurolog dermatol respirat ocular SYSTEM6 cardiac gastroin urologic the rest Figure. Box and whisker plot of age at diagnosis in years for the most common disease conditions in descending order for the Pekingese breed (N=62 dogs with 3 conditions with age reported). The dashed line ( ) is the overall median age at diagnosis for all dogs in the survey and the dotted line (----) is the overall median age at diagnosis for the Pekingese breed. The solid line within each grey box represents the median age at diagnosis from the condition.
7 Table 3. Disease conditions by organ system/category for the Pekingese breed. All conditions Disease condition N % Most common specific conditions in descending order 1 Reproductive Dystochia (uterine inertia>physical blockage); pyometra; infertility; irregular heat cycles 2 Neurologic IVDD (unspecified>lumbar>thoracic); deafness 3 Dermatologic Sebaceous cysts; dermatitis; pyotraumatic dermatitis 4 Respiratory 11.2 Kennel cough; noisy breathing; BOAS; long soft palate; rhinitis; unspecified Ocular Corneal ulcer; KCS; entropion; eye infections; enucleation 6 Cardiac Heart murmur (unspecified>without clinical signs); coughing; CHF; slow heart rate 7 Musculoskeletal 6.6 Patellar luxation; spondylitis 8 Gastrointestinal 4.6 Vomiting; gastric dilatation/volvulus (GDV); colitis; malabsorption 9 Aural Otitis externa; excessive ear wax Unknown Undiagnosed illness 11 Urologic Cystouroliths (calcium oxalate=unspecified); cystitis; incontinence (unspecified) 12 Immune mediated Atopy; food allergy 13 Trauma Unspecified 14 Cerebrovascular 1.9 Stroke or cerebral vascular accident 1 Endocrine 1.9 Diabetes mellitus Total 8. BOAS=brachycephalic obstructive airway syndrome
Report from the Kennel Club/ British Small Animal Veterinary Association Scientific Committee
Report from the Kennel Club/ British Small Animal Veterinary Association Scientific Committee Summary results of the Purebred Dog Health Survey for the Samoyed breed Warning: The results of this survey
Report from the Kennel Club/ British Small Animal Veterinary Association Scientific Committee
Report from the Kennel Club/ British Small Animal Veterinary Association Scientific Committee Summary results of the Purebred Dog Health Survey for British Bulldogs Warning: The results of this survey
Report from the Kennel Club/ British Small Animal Veterinary Association Scientific Committee
Report from the Kennel Club/ British Small Animal Veterinary Association Scientific Committee Summary results of the Purebred Dog Health Survey for French Bulldogs Warning: The results of this survey and
Report from the Kennel Club/ British Small Animal Veterinary Association Scientific Committee
Report from the Kennel Club/ British Small Animal Veterinary Association Scientific Committee Summary results of the Purebred Dog Health Survey for Old English Sheepdogs Warning: The results of this survey
Report from the Kennel Club/ British Small Animal Veterinary Association Scientific Committee
Report from the Kennel Club/ British Small Animal Veterinary Association Scientific Committee Summary results of the Purebred Dog Health Survey for Flatcoated Retrievers Warning: The results of this survey
Report from the Kennel Club/ British Small Animal Veterinary Association Scientific Committee
Report from the Kennel Club/ British Small Animal Veterinary Association Scientific Committee Summary results of the Purebred Dog Health Survey for Labrador Retrievers Warning: The results of this survey
Report from the Kennel Club/ British Small Animal Veterinary Association Scientific Committee
Report from the Kennel Club/ British Small Animal Veterinary Association Scientific Committee Summary results of the Purebred Dog Health Survey for Irish Wolfhounds Warning: The results of this survey
Report from the Kennel Club/ British Small Animal Veterinary Association Scientific Committee
Report from the Kennel Club/ British Small Animal Veterinary Association Scientific Committee Summary results of the Purebred Dog Health Survey for Cavalier King Charles Spaniels Warning: The results of
Report from the Kennel Club/ British Small Animal Veterinary Association Scientific Committee
Report from the Kennel Club/ British Small Animal Veterinary Association Scientific Committee Summary results of the Purebred Dog Health Survey for the Alaskan Malamute breed Warning: The results of this
Report from the Kennel Club/ British Small Animal Veterinary Association Scientific Committee
Report from the Kennel Club/ British Small Animal Veterinary Association Scientific Committee Summary results of the Purebred Dog Health Survey for Golden Retrievers Warning: The results of this survey
Irish Wolfhound Pedigree Breed Health Survey
Irish Wolfhound Pedigree Breed Health Survey Forms were received representing 74 living dogs & 32 deceased dogs. Mortality results A total of 32 deaths were reported, representing 0.57% of all deaths reported
Chesapeake Health Survey Results 2014
No. of dogs Chesapeake Bay Retriever Club Chesapeake Health Survey Results This health survey is the first of a two-part survey of Chesapeake Bay Retrievers in the UK, carried out by the Chesapeake Bay
Medical Surgical Nursing (Elsevier)
1 of 6 I. The Musculoskeletal System Medical Surgical Nursing (Elsevier) 1. Med/Surg: Musculoskeletal System: The Comprehensive Health History 2. Med/Surg: Musculoskeletal System: A Nursing Approach to
Dallas Neurosurgical and Spine Associates, P.A Patient Health History
Dallas Neurosurgical and Spine Associates, P.A Patient Health History DOB: Date: Reason for your visit (Chief complaint): Past Medical History Please check corresponding box if you have ever had any of
NEURO-OPHTHALMIC QUESTIONNAIRE NAME: AGE: DATE OF EXAM: CHART #: (Office Use Only)
PAGE 1 NEURO-OPHTHALMIC QUESTIONNAIRE NAME: AGE: DATE OF EXAM: CHART #: (Office Use Only) 1. What is the main problem that you are having? (If additional space is required, please use the back of this
Asteron Life Business Insurance
Asteron Life Business Insurance What lump sum covers are available with Asteron Life Business Insurance? Life Cover Life Cover pays a lump sum of money if you pass away or become terminally ill. Total
PATIENT HEALTH QUESTIONNAIRE Radiation Oncology (Patient Label)
REVIEWED DATE / INITIALS SAFETY: Are you at risk for falls? Do you have a Pacemaker? Females; Is there a possibility you may be pregnant? ALLERGIES: Do you have any allergies to medications? If, please
PATIENT / VISIT INFORMATION PATIENT INFORMATION
PATIENT / VISIT INFORMATION PATIENT INFORMATION Name of Patient: Date of Birth: Date of Visit: VISIT INFORMATION Please complete this form in its entirety, and present it to the registration desk when
The Health of British Flatcoated Retrievers
1 Analysis of 2011 Survey of The Health of British Flatcoated Retrievers Many thanks to the owners who took the time to complete the questionnaire and who also provided case histories or laboratory reports
Asteron Life Personal Insurance
Asteron Life Personal Insurance What lump sum covers are available with Asteron Life Personal Insurance? Life Cover Life Cover insurance pays a lump sum of money if you pass away or become terminally ill.
How to Remove a Social History Smoke?
AUSTIN RETINA ASSOCIATES PATIENT INFORMATION NAME: MAILING ADDRESS or NURSING HOME NAME & ADDRESS: Last First Middle Initial CITY: STATE: ZIP CODE: - TELEPHONE: HOME:( ) CELL: ( ) WORK:( ) DATE OF BIRTH:
LifeProtect. Serious illness cover. Protecting YOU FROM THE BIGGEST RISKS YOU LL FACE
LifeProtect Serious illness cover Protecting YOU FROM THE BIGGEST RISKS YOU LL FACE Important Note - Please read Zurich s Serious Illness Cover is subject to terms and conditions which are contained in
Key Facts about Influenza (Flu) & Flu Vaccine
Key Facts about Influenza (Flu) & Flu Vaccine mouths or noses of people who are nearby. Less often, a person might also get flu by touching a surface or object that has flu virus on it and then touching
NEUROSURGERY SERVICES AT APD LOCATED AT UPPER VALLEY MEDICAL GROUP 106 Hanover Street, Lebanon, NH 03766 Phone: 603.448.0447 Fax: 603.448.
DATE NEUROSURGERY SERVICES AT APD LOCATED AT UPPER VALLEY MEDICAL GROUP 106 Hanover Street, Lebanon, NH 03766 Phone: 603.448.0447 Fax: 603.448.0019 Joseph M. Phillips, M.D., Ph.D. Board Certified in Pain
Group Benefits Evidence of Insurability for Comprehensive Optional Critical Illness Insurance
Group Benefits Evidence of Insurability for Comprehensive Optional Critical Illness Insurance INSTRUCTIONS - Please print all answers If required, retain a photocopy for your files. 1a) Plan contract number(s)
Pulmonary Associates of Richmond
Pulmonary Associates of Richmond Name: Address One: City: Home Phone#: Work Phone#: Cell Phone#: State: Zip: Sex: Social Security Number: Referring Doctor: of Birth: Employer: Primary Care Doctor: Employment
St. Luke s MS Center New Patient Questionnaire. Name: Date: Birth date: Right or Left handed? Who is your Primary Doctor?
St. Luke s MS Center New Patient Questionnaire Name: Date: Birth date: Right or Left handed? Who is your Primary Doctor? Who referred you to the MS Center? List any other doctors you see: Reason you have
The insurance company checked above (Company) is responsible for the obligation and payment of benefits under any policy that it may issue.
American International Life Assurance Company of New York* Home Office: 80 Pine Street, New York, NY 10005 The United States Life Insurance Company in the City of New York* Home Office: 830 Third Avenue,
Women s Continence and Pelvic Health Center
Women s Continence and Pelvic Health Center Committed to Caring 580-590 Court Street Keene, New Hampshire 03431 (603) 354-5454 Ext. 6643 URINARY INCONTINENCE QUESTIONNAIRE The purpose of this questionnaire
WORKERS COMPENSATION INFORMATION
WORKERS COMPENSATION INFORMATION PATIENT REGISTRATION INFORMATION 15215 Shady Grove Rd. # 100 Patient Name: Last First MI Address: Street City State Zip Home Phone: Cell Phone: Work Phone: Primary Doctor:
Insured Party Information (please complete if the insurance is not in your name)
Price M. Kloess, M.D. / Andrew J. Velazquez, M.D. / J. Randall Pitts, M.D. Holly Young, O.D./ Audrey Richards, O.D./ Brittany M. Mitchell, O.D. Patient Registration and Financial Agreement Patient s Dr
Medicare Patient Information. Patient Name: SS#: - - Date of Birth: / / Sex: Female Male. City: State: Zip Code:
Medicare Patient Information Patient Name: SS#: - - Date of Birth: / / Sex: Female Male Address: Street: City: State: Zip Code: Home Phone: ( ) - Work/Mobile Phone: ( ) - Please print your name as it Appears
1MFBTF GJMM PVU GPSNT BOE GBY 'PSNT XJMM CF TJHOFE BU ZPVS BQQPJOUNFOU
CELL PHONE: PATIENT HISTORY FORM - CONFIDENTIAL DATE: PATIENT: (LAST NAME) (FIRST NAME) (Ml) (NICKNAME) DOB: Primary Physician/ Family Doctor: Phone: Past Medical History (Click all that apply) High blood
Generali Worldwide Group Health Insurance Enrolment and Health Insurance Applicant Form
Generali Worldwide Group Health Insurance Enrolment and Health Insurance Applicant Form Please complete all sections in BLOCK CAPITALS or tick the boxes, where appropriate. A completed Health Insurance
A Guide for Successfully Completing the Group Disability Insurance Evidence of Insurability Form
A Guide for Successfully Completing the Group Disability Insurance Evidence of Insurability Form Mutual of Omaha appreciates the opportunity to provide you with valuable income protection. So that we can
Non-covered ICD-10-CM Codes for All Lab NCDs
Non-covered ICD-10-CM s for All Lab NCDs This section lists codes that are never covered by Medicare for a diagnostic lab testing service. If a code from this section is given as the reason for the test,
1584 Wesleyan Drive FORM A Norfolk, VA 23504 Phone: (757) 455-3108 Health History immunization & Physical Form
Mail completed form to: Marlin Health Services 1584 Wesleyan Drive FORM A Norfolk, VA 23504 Phone: (757) 455-3108 Health History immunization & Physical Form Virginia State law (code 23-7.5) requires all
Full name DOB Age Address Email Phone numbers (H) (W) (C) Emergency contact Phone
DEMOGRAPHIC INFORMATION Full name DOB Age Address Email Phone numbers (H) (W) (C) Emergency contact Phone CARE INFORMATION Primary care physician: Address Phone Fax Referring physician: Specialty Address
Application Form. New application Change my current plan/deductible. Add spouse/partner/dependents Reinstatement
Application Form Important: Please make sure all the information required on this health insurance application has been provided. Best Doctors Insurance Limited reserves the right to contact the if a question
CIGNA GLOBAL HEALTH OPTIONS APPLICATION FORM HELLO
CIGNA GLOBAL HEALTH OPTIONS APPLICATION FORM HELLO We re glad you would like to join us. Please complete this application form and return it to us, either by electronic mail, fax or post. See our contact
A Guide for Successfully Completing the Group Disability Insurance Evidence of Insurability Form
A Guide for Successfully Completing the Group Disability Insurance Evidence of Insurability Form Mutual of Omaha appreciates the opportunity to provide you with valuable income protection. So that we can
ORTHOPAEDIC SPINE PAIN QUESTIONNAIRE
ORTHOPAEDIC SPINE PAIN QUESTIONNAIRE NAME: DATE: ADDRESS: AGE: TELEPHONE#: RELIGION: OCCUPATION: REFERRED BY WHOM: NEAREST FRIEND/RELATIVE: TELEPHONE#: ADDRESS: PLEASE EXPLAIN WHY YOU HAVE COME TO SEE
Consent for Treatment/Procedure Laparoscopic Sleeve Gastrectomy
Patient's Name: Today's Date: / / The purpose of this document is to confirm, in the presence of witnesses, your informed request to have Surgery for obesity. You are asked to read the following document
PLEASE PRINT LEGIBLY
Patient Information PLEASE PRINT LEGIBLY Patients Name: Date of Birth: Sex: Patients Address: City: State: Zip: Home Phone: Cell: Work: Email: SSN: Employer: Occupation: Marital Status: Employed: Full
MEDICAL-SURGICAL EYE CARE, P.A.
MEDICAL-SURGICAL EYE CARE, P.A. DATE PATIENT'S NAME: ADDRESS: CITY/STATE/ZIP: DATE OF BIRTH: MARTIAL STATUS: M S D W HOME PHONE: ( ) SEX: M F AGE: CELLPHONE: ( ) IF CHILD; PARENT OR GUARDIAN NAME: EMERGENCY
POINCIANA INTERNAL MEDICINE PA. Patient Name: Social Security Number: Date of Birth: / / Sex: M/F (Circle One) Married/Single/Divorced/Widow Address:
Patient Name: Social Security Number: Date of Birth: / / Sex: M/F (Circle One) Married/Single/Divorced/Widow Address: (Street) (City/State/Zip) Home Phone: ( ) E Mail Address: Would you be interested in
New England Pain Management Consultants At New England Baptist Hospital
New England Pain Management Consultants At New England Baptist Hospital Pain Management Center Health Assessment Dear New Pain Management Patient, Welcome to the New England Pain Management Consultants
INDIVIDUAL LIFE INSURANCE APPLICATION PART II - MEDICAL EXAMINATION
INDIVIDUAL LIFE INSURANCE APPLICATION PART II - MEDICAL EXAMINATION ReliaStar Life Insurance Company, 20 Washington Avenue South, Minneapolis, MN 55401 Security Life of Denver Insurance Company, 1290 Broadway,
Sun Life and Health Insurance Company (U.S.)
Sun Life and Health Insurance Company (U.S.) One Sun Life Executive Park, Wellesley Hills, MA 02481] [800-247-6875 Evidence of Insurability Cover Page Employer Instructions Complete this cover page and
Limited Pay Policy (L-222B) - Underwriting Guidelines
Limited Pay Policy (L-222B) - Underwriting Guidelines 1 Addiction/Abuser Drug - Past or Present Presently Recovered - AA for last 2 years 2 Aids 3 Alcoholic Presently Recovered - AA for last 2 years 4
Healthcare services requiring prior authorisation
Annex 2 Healthcare requiring prior authorisation This list does not include organ transplants and does also not apply to long-term care and the primary purpose of which is to support people in need of
NEW PATIENT CONSULTATION FORM. Social Security Number - - Date of Birth Age. Home Address. Home phone Cell phone. Work phone Email address
NEW PATIENT CONSULTATION FORM Welcome to our office. Please fill out the first four pages. Date Name Social Security Number - - Date of Birth Age Home Address Home phone Cell phone Work phone Email address
SOUTH TAMPA MULTIPLE SCLEROSIS CENTER
SOUTH TAMPA MULTIPLE SCLEROSIS CENTER PATIENT/CARE GIVER QUESTIONNAIRE DEMOGRAPHIC INFORMATION Patient's Name: City: State: Zip Code: Phone: Marital Status: Spouse/Care Giver Name: Phone (H) (W) Occupation:
Patient Medical History
Cardiovascular Abnormal Electrocardiogram Aortic Stenosis Atrial fibrillation Cardiac arrest Chest pain Congestive heart failure Heart valve replacement Hypertension Murmur Heart attack Palpitations Peripheral
Risk Insurance Definitions of the Critical Illness benefits. Dr. Eric Starke Insurance Medical Advisor
Risk Insurance Definitions of the Critical Illness benefits Dr. Eric Starke Insurance Medical Advisor Why a Critical Illness benefit? A living benefit for a dreaded disease. Dr. Barnard once said the outcome
For intermediary use only not for use with your clients. Medical condition guide
For intermediary use only not for use with your clients Medical condition guide Introduction Listed in this guide are the most common medical disclosures we are asked about. You will find an explanation
MEDICAL HISTORY AND SCREENING FORM
MEDICAL HISTORY AND SCREENING FORM The purpose of preventive exams is to screen for potential health problems and provide education to promote optimal health. It is best practice for chronic health problems
Emory Eye Center New Patient Questionnaire
Patient Name: Date: Current Address: Current Phone: Date of Birth: Primary Care Physician: Referring Physician: (First & Last Name) (First & Last Name) Pharmacy Name: Phone #: ( ) Please answer all questions
Markham Stouffville Hospital
Markham Stouffville Hospital Adult Diabetes Education Frequently Asked Questions What is diabetes? Diabetes is a disease in which blood glucose levels are above normal. Most of the food we eat is turned
Zurich Life Risk Trauma cover
Product Summary Issued 21 December 2015 Zurich Life Risk Trauma cover Adviser use only Trauma insurance provides a lump sum payment on diagnosis or occurrence of a covered trauma. This is a summary only
How To Fill Out A Health Declaration
The English translation has no legal force and is provided to the customer for convenience only. The Dutch health declaration should be filled in. Health declaration for occupational disability insurance
PATIENT INFORMATION INSURANCE INFORMATION
(mm/dd/yyyy): Have you been to Physicians Urgent Care before? Yes No Arrival Time: If yes, when? Is this a follow-up to a previous visit: Yes No PATIENT INFORMATION Patient s First Name: Middle Name: Last
Notice of Privacy Practices
Notice of Privacy Practices This notice describes how medical information about you may be used and disclosed, and how you may obtain access to this information. Please review it carefully. OMAC respects
PLEASE COMPLETE PRIOR TO VISIT***Place your name at the bottom of each sheet
PLEASE COMPLETE PRIOR TO VISIT***Place your name at the bottom of each sheet GASTROINTESTINAL ASSOCIATES, INC. PATIENT REGISTRATION Welcome to our practice. Please complete all sections of this registration
PATIENT INFORMATION / / OTHER CONTACT NUMERS: (CIRCLE ONE) CELL, HOME OR OTHER. ENTER NUMBER BELOW. ( ) EMPLOYER ( )
PATIENT INFORMATION PATIENT S LEGAL NAME DATE OF BIRTH AGE DATE / / / / HEIGHT AND WEIGHT SEX REASON FOR VISIT: MARITAL STATUS FT IN LBS MALE FEMALE S M D W ADDRESS CITY STATE ZIP CODE THE BEST NUMBER
TALLAHASSEE EYE CENTER
TALLAHASSEE EYE CENTER PATIENT INFORMATION Date: Name: Gender: M / F First MI Last Date of Birth: / / Address: City: State: ZIP: Phone Numbers: Home: Cellular: Work: E-Mail: SS#: - - What is the best way
SUMMARY OF FINDINGS: OMF 2015 MEDICAL NEEDS ASSESSMENT
SUMMARY OF FINDINGS: OMF 2015 MEDICAL NEEDS ASSESSMENT DEMOGRAPHICS Total surveys completed: 341 62 % Eastsound area 13 % Deer Harbor area 16 % Olga area 9 % Orcas Ferry area Age 2 % 25 34 8 % 35 44 13
PATIENT INFORMATION (Please Print) Patient First Middle Initial Last. Email : ( Please avoid using Work Email Address)
PATIENT INFORMATION (Please Print) Date: Patient First Middle Initial Last Birthdate: / / Marital Status: Address: City: State: Zip Code: Primary Phone: ( ) Secondary Phone: ( ) By supplying your email
AA Critical Illness with Life Cover Policy Summary
AA Critical Illness with Life Cover Policy Summary The Financial Services Authority is the independent financial services regulator. It requires us, Friends Life and Pensions Limited, to give you important
Asteron Life Personal Insurance
Asteron Life Personal Insurance Policy Document How to contact us If you need to make a claim Call us on 0800 737 101 Email us at claims@asteronlife.co.nz Fax us on 0800 808 144 or 04 495 8851 Write to
RETINA CARE CENTER, P.C. PATIENT INFORMATION
RETINA CARE CENTER, P.C. JONATHAN M. BAROFSKY, M.D., F.A.C.S. Parkway Seventy Plaza 1255 Route 70, Suite 31N Lakewood, New Jersey 08701 PHONE (732)905 0004 FAX (732)905 3868 PATIENT INFORMATION Welcome
Associates in Pediatric & Adult Urology, PA A division of Garden State Urology 282 Route 46 PO Box 1160 Denville, NJ 07834
Associates in Pediatric & Adult Urology, PA A division of Garden State Urology 282 Route 46 PO Box 1160 Denville, NJ 07834 Dear New Patient: Welcome to Associates in Pediatric and Adult Urology, PA, a
Alameda Alliance for Heath ICD-9 to ICD-10 TRANSLATION CODES E10.10
DIABETES ICD-9 CM ICD-9 CM Volume 1 - Diagnosis Description ICD-10 CM - Diagnosis Code ICD-10 CM - Diagnosis Description 250.00 Diabetes mellitus without mention of complication, type II or unspecified
Critical Illness Insurance. Second Chance for Children 30 days to 17 years
Critical Illness Insurance Second Chance for Children 30 days to 17 years Second Chance for Children Protect your children in case of critical illness so you can afford to stay by their bedside If one
GUIDE. Prepare for Your Phone Interview and Medical Exam.
GUIDE Prepare for Your Phone Interview and Medical Exam. WHAT YOU NEED TO HAVE, KNOW, AND DO. All information gathered during the interview and exam will be shared only with those who need it in order
Patient Checklist. Expect to pay your co-pays and non-covered services on the day of service.
Welcome to Cedar Run Eye Center. We look forward to your visit with us! Enclosed you will find: Registration Form History Form Patient check list with a map on the back side Patient Name: Date of Appointment:
PART A GENERAL INFORMATION
Flexcare Application for Quebec Residents The Manufacturers Life Insurance Company AIR MILES Collector #: 8 WSE *All applicants must complete parts A, B, C, D PART A GENERAL INFORMATION Applicant s First
Life & PHI Application Form
Life & PHI Application Form A. Applicant 1) Mr Mrs Miss Other: 2) Family Name: 3) First Name: 4) Date of Birth: 5) Nationality: 6) Place of Birth: 7) Location of Assignment: 7) Occupation (please give
PHC4 35 Diseases, Procedures, and Medical Conditions for which Laboratory Data is Required Effective 10/1/2015
PHC4 35 Diseases, Procedures, and Medical Conditions for which Laboratory Data is Required Effective 10/1/2015 Laboratory data is to be submitted for discharges in the following conditions: 1. Heart Attack
Enjoy a position of vantage, come what may.
Enjoy a position of vantage, come what may. prucrisis covervantage While you have achieved much in life and you and your family enjoy the benefits of success, there may be times when the unexpected happens.
PREMIER PAIN CARE PA Carlos J Garcia MD 2435 W. Oak Street # 103 Denton, TX 76201 Phone 940-323-9404 Fax 940-323-9422 PATIENT REGISTRATION
PREMIER PAIN CARE PA Carlos J Garcia MD 2435 W. Oak Street # 103 Denton, TX 76201 Phone 940-323-9404 Fax 940-323-9422 PATIENT REGISTRATION Last Name First Name MI Mailing Address City Zip code Home Phone
Figure 1: DWDA prescription recipients and deaths*, by year, Oregon, 1998-2014
Oregon s Death with Dignity Act--214 Oregon s Death with Dignity Act (DWDA), enacted in late 1997, allows terminally-ill adult Oregonians to obtain and use prescriptions from their physicians for self-administered,
Critical Illness Insurance. What is Critical Illness Insurance
Critical Illness Insurance What is Critical Illness Insurance Whereas life insurance has been readily available for literally hundreds of years, critical illness insurance is a relatively recent development.
We have made the following changes to the Critical Illness events covered under our group critical illness policy.
We have made the following changes to the Critical Illness events covered under our group critical illness policy. March 2015 Because everyone needs a back-up plan 7 New critical illness events added to
Policy Summary of Friends Life Individual Protection Critical Illness with Life Cover
Policy Summary of Friends Life Individual Protection Critical Illness with Life Cover FLIP/4569/Mar15 This policy summary gives you important information about the Friends Life Individual Protection Critical
Denver Spine Surgeons David Wong, MD, Sanjay Jatana, MD, Gary Ghiselli, MD
Cervical and Lumbar Spine Health History Name: Today s Date: Referring Provider: How did you find us: (Please circle) Primary care physician, Google search, Facebook, Friend or Family member, Website (JatanaSpine
Policy Summary of Friends Life Individual Protection Critical Illness with Life Cover
Policy Summary of Friends Life Individual Protection Critical Illness with Life Cover FLIP/4569/Mar15 This policy summary gives you important information about the Friends Life Individual Protection Critical
Critical Illness with Term Assurance
AIG Life Critical Illness with Term Assurance Our comprehensive Critical Illness with Term Assurance delivers more value and quality to the customer and their family than ever before. It is designed to
THE CHARTERED INSURANCE INSTITUTE. Unit P61 Life, critical illness and disability underwriting
THE CHARTERED INSURANCE INSTITUTE P61 Diploma in Insurance Unit P61 Life, critical illness and disability underwriting April 2015 examination Instructions Three hours are allowed for this paper. Do not
Facing the challenges of CRITICAL ILLNESS
Facing the challenges of CRITICAL ILLNESS INTRODUCTION What is insurance? In life, we are all faced with threats which, if they occurred, would result in financial loss Insurance is the process of protecting
For customers Friends Life Individual Protection Critical Illness Cover. Critical Illness Cover. It s critical illness. And more.
For customers Friends Life Individual Protection Critical Illness Cover Critical Illness Cover It s critical illness. And more. It s critical illness. And 2 it s designed with your needs in mind. it covers
Affordable Health Insurance for Pets. all about
all about VPI Pet Insurance The Trusted Choice of America s Pet Lovers Since 1982 just the facts: What is VPI Pet Insurance? VPI Pet Insurance provides health and accident insurance for dogs, cats, birds
Your Guide to Express Critical Illness Insurance Definitions
Your Guide to Express Critical Illness Insurance Definitions Your Guide to EXPRESS Critical Illness Insurance Definitions This guide to critical illness definitions will help you understand the illnesses
Understanding Mortality Statistics: The Importance of Cause-of-Death Certification and Coding
Understanding Mortality Statistics: The Importance of Cause-of-Death Certification and Coding Robert N. Anderson, PhD Arialdi M. Miniño, MPH Mortality Statistics Branch Division of Vital Statistics Centers
Open the Flood Gates Urinary Obstruction and Kidney Stones. Dr. Jeffrey Rosenberg Dr. Emilio Lastarria Dr. Richard Kasulke
Open the Flood Gates Urinary Obstruction and Kidney Stones Dr. Jeffrey Rosenberg Dr. Emilio Lastarria Dr. Richard Kasulke Nephrology vs. Urology Nephrologist a physician who has been trained in the diagnosis
Name Today's Date Sex. Street Address City State Zip Code. Home # Work # Cell # Would you like to receive text confirmations:
Patient Information 219 Old Hook Road Westwood, NJ 07675 Office: (201) 664-0847 Fax: (201) 664 8890 E-Mail: Mail@2020nj.com Thank you for choosing Valley Eye Associates for you eyecare needs. Please complete
Disability Evaluation Under Social Security
Disability Evaluation Under Social Security Revised Medical Criteria for Evaluating Endocrine Disorders Effective June 7, 2011 Why a Revision? Social Security revisions reflect: SSA s adjudicative experience.
We understand you want support right from the beginning
PROTECT We understand you want support right from the beginning PRUearly stage crisis cover Should an illness strike, the earlier it is diagnosed, the easier it is to manage and the higher the chances
PATIENT CONSENT TO PROCEDURE - ROUX-EN-Y GASTRIC BYPASS
As a patient you must be adequately informed about your condition and the recommended surgical procedure. Please read this document carefully and ask about anything you do not understand. Please initial
Patient Registration Form
PATIENT INFORMATION Patient Registration Form (Please Print) Dr. Miss Mr. Mrs. Ms. Sir Jr. Sr. Patient s Name (Last) (First) (MI) Previous Name Mailing Address City, State, ZIP (+4) Physical Address City,