CONTENTS SECTION 1 FUNDAMENTALS 1 SECTION 2 DRUGS 75 SECTION 3 DIGESTIVE DISORDERS 109. A Guide for Readers Understanding Medical Terms
|
|
|
- Baldwin Bates
- 7 years ago
- Views:
Transcription
1 CONTENTS A Guide for Readers xxxix Understanding Medical Terms xli SECTION 1 FUNDAMENTALS 1 1 The Human Body 2 2 Genetics 8 3 Making the Most of Health Care 17 4 Prevention 28 5 Exercise and Fitness 38 6 Rehabilitation 45 7 Death and Dying 57 8 Legal and Ethical Issues 67 SECTION 2 DRUGS 75 9 Overview of Drugs Administration and Kinetics of Drugs Drug Dynamics Factors Affecting Response to Drugs Adverse Drug Reactions Adherence to Drug Treatment Trade-Name and Generic Drugs Over-the-Counter Drugs 104 SECTION 3 DIGESTIVE DISORDERS Biology of the Digestive System Symptoms and Diagnosis of Digestive Disorders Esophageal Disorders Peptic Disorders Gastroenteritis Hiatus Hernia, Bezoars, and Foreign Bodies Pancreatitis Malabsorption Inflammatory Bowel Diseases 168 vii
2 viii Contents 26 Clostridium difficile Induced Colitis Diverticular Disease Irritable Bowel Syndrome Anal and Rectal Disorders Tumors of the Digestive System Gastrointestinal Emergencies 201 SECTION 4 LIVER AND GALLBLADDER DISORDERS Biology of the Liver and Gallbladder Diagnostic Tests for Liver, Gallbladder, and Biliary Disorders Manifestations of Liver Disease Fatty Liver, Cirrhosis, and Related Disorders Hepatitis Blood Vessel Disorders of the Liver Tumors of the Liver Gallbladder and Bile Duct Disorders 242 SECTION 5 KIDNEY AND URINARY TRACT DISORDERS Biology of the Kidneys and Urinary Tract Symptoms and Diagnosis of Kidney and Urinary Tract Disorders Kidney Failure Dialysis Kidney Filtering Disorders Blood Vessel Disorders of the Kidneys Tubular and Cystic Kidney Disorders Urinary Incontinence Obstruction of the Urinary Tract Urinary Tract Infections Injury to the Urinary Tract Cancers of the Kidney and Urinary Tract 311 SECTION 6 HEART AND BLOOD VESSEL DISORDERS Biology of the Heart and Blood Vessels Symptoms and Diagnosis of Heart and Blood Vessel Disorders High Blood Pressure Low Blood Pressure Shock 350
3 Contents ix 57 Heart Failure Cardiomyopathy Abnormal Heart Rhythms Heart Valve Disorders Infective Endocarditis Pericardial Disease Heart Tumors Atherosclerosis Coronary Artery Disease Peripheral Arterial Disease Aneurysms and Aortic Dissection Venous Disorders Lymphatic Disorders 440 SECTION 7 LUNG AND AIRWAY DISORDERS Biology of the Lungs and Airways Symptoms and Diagnosis of Lung Disorders Rehabilitation for Lung and Airway Disorders Acute Bronchitis Pneumonia Abscess in the Lungs Asthma Chronic Obstructive Pulmonary Disease Sleep Apnea Pulmonary Embolism Bronchiectasis Atelectasis Environmental Lung Diseases Interstitial Lung Diseases Allergic and Autoimmune Diseases of the Lungs Pleural Disorders Pulmonary Hypertension Respiratory Failure and Acute Respiratory Distress Syndrome Cancer of the Lungs 528 SECTION 8 BONE, JOINT, AND MUSCLE DISORDERS Biology of the Musculoskeletal System Symptoms and Diagnosis of Musculoskeletal Disorders 538
4 x Contents 91 Osteoporosis Paget s Disease of Bone Osteonecrosis Bone and Joint Tumors Bone and Joint Infections Joint Disorders Autoimmune Disorders of Connective Tissue Vasculitic Disorders Gout and Pseudogout Hand Disorders Foot Problems Muscular Dystrophies and Related Disorders Muscle, Bursa, and Tendon Disorders 615 SECTION 9 BRAIN, SPINAL CORD, AND NERVE DISORDERS Biology of the Nervous System Diagnosis of Brain, Spinal Cord, and Nerve Disorders Pain Headaches Dizziness and Vertigo Sleep Disorders Brain Dysfunction Delirium and Dementia Stupor and Coma Seizure Disorders Stroke Head Injuries Tumors of the Nervous System Infections of the Brain and Spinal Cord Prion Diseases Movement Disorders Multiple Sclerosis and Related Disorders Spinal Cord Disorders Low Back and Neck Pain Peripheral Nerve Disorders Autonomic Nervous System Disorders Cranial Nerve Disorders 835
5 Contents xi SECTION 10 MENTAL HEALTH DISORDERS Overview of Mental Health Care Somatoform Disorders Anxiety Disorders Mood Disorders Suicidal Behavior Eating Disorders Personality Disorders Dissociative Disorders Schizophrenia and Delusional Disorder Sexuality 895 SECTION 11 DISORDERS OF NUTRITION AND METABOLISM Overview of Nutrition Undernutrition Vitamins Minerals and Electrolytes Obesity and the Metabolic Syndrome Cholesterol Disorders Water Balance Acid-Base Balance Porphyrias 975 SECTION 12 HORMONAL DISORDERS Biology of the Endocrine System Pituitary Gland Disorders Thyroid Gland Disorders Adrenal Gland Disorders Diabetes Mellitus Hypoglycemia Multiple Endocrine Neoplasia Syndromes Carcinoid Tumors 1018 SECTION 13 BLOOD DISORDERS Biology of Blood Symptoms and Diagnosis of Blood Disorders 1023
6 xii Contents 155 Blood Transfusion Anemia Bleeding and Clotting Disorders White Blood Cell Disorders Plasma Cell Disorders Leukemias Lymphomas Myeloproliferative Disorders Spleen Disorders 1071 SECTION 14 CANCER Overview of Cancer Symptoms and Diagnosis of Cancer Prevention and Treatment of Cancer 1086 SECTION 15 IMMUNE DISORDERS Biology of the Immune System Immunodeficiency Disorders Allergic Reactions Autoimmune Disorders Transplantation 1128 SECTION 16 INFECTIONS Biology of Infectious Disease Immunization Bacterial Infections Bacteremia, Sepsis, and Septic Shock Antibiotics Tuberculosis Leprosy Rickettsial and Related Infections Parasitic Infections Fungal Infections Viral Infections Human Immunodeficiency Virus Infection Sexually Transmitted Diseases 1264
7 Contents xiii SECTION 17 SKIN DISORDERS Biology of the Skin Diagnosis and Treatment of Skin Disorders Itching and Noninfectious Rashes Acne Pressure Sores Sweating Disorders Hair Disorders Pigment Disorders Blistering Diseases Parasitic Skin Infections Bacterial Skin Infections Fungal Skin Infections Viral Skin Infections Sunlight and Skin Damage Noncancerous Skin Growths Skin Cancers Nail Disorders 1337 SECTION 18 MOUTH AND DENTAL DISORDERS Biology of the Mouth Lip and Tongue Disorders Salivary Gland Disorders Mouth Sores Mouth Growths Tooth Disorders Periodontal Diseases Temporomandibular Disorders Urgent Dental Problems 1371 SECTION 19 EAR, NOSE, AND THROAT DISORDERS Biology of the Ears, Nose, and Throat Hearing Loss and Deafness Outer Ear Disorders Middle and Inner Ear Disorders Nose, Sinus, and Taste Disorders Throat Disorders Nose and Throat Cancers 1406
8 xiv Contents SECTION 20 EYE DISORDERS Biology of the Eyes Symptoms and Diagnosis of Eye Disorders Refractive Disorders Injuries to the Eye Eyelid and Tearing Disorders Conjunctival and Scleral Disorders Corneal Disorders Cataract Uveitis Glaucoma Retinal Disorders Optic Nerve Disorders Eye Socket Disorders 1462 SECTION 21 MEN S HEALTH ISSUES Male Reproductive System Penile and Testicular Disorders Prostate Disorders Sexual Dysfunction in Men 1482 SECTION 22 WOMEN S HEALTH ISSUES Female Reproductive System Symptoms and Diagnosis of Gynecologic Disorders Sexual Dysfunction in Women Menopause Menstrual Disorders and Abnormal Vaginal Bleeding Endometriosis Fibroids Vaginal Infections Pelvic Inflammatory Disease Pelvic Floor Disorders Breast Disorders Noncancerous Gynecologic Abnormalities Cancers of the Female Reproductive System Violence Against Women 1581
9 Contents xv 249 Infertility Family Planning Detection of Genetic Disorders Normal Pregnancy High-Risk Pregnancy Pregnancy Complicated by Disease Pregnancy and Drug Use Complications of Pregnancy Normal Labor and Delivery Complications of Labor and Delivery Postdelivery Period 1665 SECTION 23 CHILDREN S HEALTH ISSUES Newborns and Infants Problems in Newborns Birth Defects Chromosomal and Genetic Abnormalities Problems in Infants and Very Young Children Preschool and School-Aged Children Behavioral and Developmental Problems in Young Children Adolescents Problems in Adolescents Bacterial Infections Viral Infections Respiratory Disorders Cystic Fibrosis Digestive Disorders Neurologic Disorders Ear, Nose, and Throat Disorders Eye Disorders Bone Disorders Hereditary Connective Tissue Disorders Juvenile Idiopathic Arthritis Diabetes Mellitus Hereditary Metabolic Disorders Hereditary Periodic Fever Syndromes Childhood Cancers Learning and Developmental Disorders Cerebral Palsy 1856
10 xvi Contents 286 Mental Retardation/Intellectual Disability Mental Health Disorders Social Issues Affecting Children and Their Families Child Neglect and Abuse 1879 SECTION 24 OLDER PEOPLE S HEALTH ISSUES The Aging Body Aging and Drugs Provision of Care Health Care Coverage for Older People Long-Term Care Coping With Changes Related to Aging Driving Falls Elder Mistreatment 1934 SECTION 25 INJURIES AND POISONING First Aid Burns Fractures Sports Injuries Heat Disorders Cold Injuries Radiation Injury Electrical and Lightning Injuries Drowning Diving and Compressed Air Injuries Altitude Illness Poisoning Bites and Stings 2015 SECTION 26 SPECIAL SUBJECTS The Science of Medicine and Clinical Trials Medical Decision Making Common Imaging Tests Hospital Care Surgery Complementary and Alternative Medicine 2059
11 Contents xvii 318 Medicinal Herbs and Nutraceuticals Drug Use and Abuse Travel and Health Amyloidosis Disorders of Unknown Cause 2109 APPENDIXES 2113 I Weights and Measures 2113 II Common Medical Tests 2116 III Drug Names: Generic and Trade 2124 IV Resources for Help and Information 2151 INDEX 2165
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
Medical Specialties Guide
Medical Specialties Guide Allergy And Immunology Specialists in this field treat disorders related to how the body reacts to foreign substances. They treat such things as seasonal allergies, eczema, asthma,
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
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
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
Medical Matters Action Checklists
Medical Matters Action Checklists The following Action Checklists are included in Chapter 5: Medical History Personal Medication Record Health Care Power of Attorney Medical Orders (Do Not Resuscitate/POLST)
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,
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
Dental Admission Form
Dental Admission Form PERSONAL HISTORY All of the information which you provide on this form will be held in the strictest confidence. Although some questions may seem unimportant at the time, they may
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
ORGAN SYSTEMS OF THE BODY
ORGAN SYSTEMS OF THE BODY DEFINITIONS AND CONCEPTS A. Organ a structure made up of two or more kinds of tissues organized in such a way that they can together perform a more complex function that can any
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
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
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
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
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
Translated version of Genomsnit.. (1).doc
Translated version of Genomsnit.. (1).doc The average general medicine specialist s work in Sweden A general medicine specialist s work in Sweden differs from most other EU countries in that it includes
New Patient Intake Form
New Patient Intake Form Title: (Circle one) Mr. Mrs. Ms. Miss Dr. Other First Name Middle Initial Last Name Address City State Zip Code Leave Messages on: (Circle one) Home Cell Work Don t leave messages
Surgery Health Survey
Surgery Health Survey Name: Social Security Number: Date of Birth: Please tell us which physician(s) we should contact regarding your visit: REFERRING PHYSICIAN Name: Address: PRIMARY CARE PHSYICIAN Name:
ARTICLE #1 PLEASE RETURN AT THE END OF THE HOUR
ARTICLE #1 PLEASE RETURN AT THE END OF THE HOUR Alcoholism By Mayo Clinic staff Original Article: http://www.mayoclinic.com/health/alcoholism/ds00340 Definition Alcoholism is a chronic and often progressive
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
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
5 Burden of disease and injury
5 Burden of disease and injury 5.1 Overview In this chapter, we present the results of the Australian Burden of Disease and Injury Study for the total disease burden measured in by age, sex and cause for
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
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
NEW PATIENT HISTORY QUESTIONNAIRE. Physician Initials Date PATIENT INFORMATION
NEW PATIENT HISTORY QUESTIONNAIRE Physician Initials Date PATIENT INFORMATION JHH# DOB# AGE HOME PH CELL PH DAY PH EMAIL Who is your REFERRING PHYSICIAN? (The doctor who referred you to Johns Hopkins Neurology.)
Covers 60 major critical illnesses. Covers 11 minor critical illnesses. ManuMulti Care
It s a difficult subject to think about, but part of planning for the future is being prepared for the unexpected. Critical illness can happen to anyone, at any time. And it s an unfortunate fact, but
Roswell Ear, Nose, Throat, & Allergy 342 W. Sherrill Lane Suite A, Roswell, New Mexico 88201 (575)-622-2911 Fax: (575)-622-2598
Roswell Ear, Nose, Throat, & Allergy 342 W. Sherrill Lane Suite A, Roswell, New Mexico 88201 (575)-622-2911 Fax: (575)-622-2598 Patient Registration Form: (Please Print all Pertinent Information) Last
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:
This notice provides a safe harbor for preventive care benefits allowed to. be provided by a high deductible health plan (HDHP) without satisfying the
Part III - Administrative, Procedural, and Miscellaneous Notice 2004-23 PURPOSE This notice provides a safe harbor for preventive care benefits allowed to be provided by a high deductible health plan (HDHP)
BREAST HEALTH HISTORY FORM
BREAST HEALTH HISTORY FORM Name Date of Visit: Date of Birth: Age: REFERRING PHYSICIANS: please include name, address and phone number of all physicians whom you would like to receive report of today s
Long Term Use of Antacid Medications Can Cause an Increased Risk for Osteoporosis and Much More
Long Term Use of Antacid Medications Can Cause an Increased Risk for Osteoporosis and Much More By: Jeremie Pederson D.C., C.S.C.S. Many people are concerned about the FDA news release dated May 25, 2010
Georgia Department of Human Resources BACKGROUND INFORMATION FOR NON-STATE AGENCY CHILD
Georgia Department of Human Resources BACKGROUND INFORMATION FOR NON-STATE AGENCY CHILD Responsible Party Telephone Number Date Name of Child Date of Birth Time of Birth Sex Resident County Placement County
Patient & Medical Professional US Online Panel
Patient & Medical Professional US Online Panel Patient & Medical Professional US Online Panel Over 500K validated US online double opt-in panelists motivated to share their opinions in research! Since
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
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
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
Borland-Groover Clinic PATIENT GENERATED MEDICAL HISTORY Name: DOB: Email: Primary Care Physician: Pharmacy: Pharmacy Phone #:
PATIENT GENERATED MEDICAL HISTORY Name: DOB: Email: Primary Care Physician: Referring: Pharmacy: Pharmacy Phone #: Place Sticker Here Directions: Please circle any of the following you have personally
Application For Admission To The Non-Surgical Spinal Decompression Program At The Spinal Decompression Center of Long Beach
Application For Admission To The Non-Surgical Spinal Decompression Program At The Spinal Decompression Center of Long Beach If you are reading this form, you have qualified for a consultation with Dr.
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
GASTRIC BYPASS SURGERY CONSENT FORM
Page 1 of 6 I, have been asked to read carefully all of the (name of patient or substitute decision-maker) information contained in this consent form and to consent to the procedure described below on
PATIENT HISTORY FORM
PATIENT HISTORY FORM If you are new to the office, have not been seen in over one (1) year, or are returning for a new problem, please complete this form in full. If there have been any changes since your
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.
Normal Age Related Changes and Developmental Disability
Normal and Developmental Disability Excerpts From: Growing Older with A Developmental Disability: Physical and Cognitive Changes and Their Implications. University of Illinois at Chicago VISION: Changes
Evidence-Based Practice for Public Health Identified Knowledge Domains of Public Health
1 Biostatistics Statistical Methods & Theory Evidence-Based Practice for Public Health Identified Knowledge Domains of Public Health General Public Health Epidemiology Risk Assessment Population-Based
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
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
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
Certified Clinical Documentation Specialist Examination Content Outline - 2016
Certified Clinical Documentation Specialist Examination Content Outline - 2016 1. Healthcare Regulations, Reimbursement, and Documentation Requirements Related to the Inpatient Prospective Payment System
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.
PATIENT INFORMATION: PATIENT CONTACT PHONE NUMBERS: PHYSICIAN INFORMATION: HEALTH INSURANCE INFORMATION:
PATIENT INFORMATION: TODAY S DATE: HOW DID YOU HEAR ABOUT US?: LAST NAME: FIRST NAME: STREET CITY: STATE: ZIP: EMAIL MARTIAL STATUS: SINGLE MARRIED DIVORCED WIDOWED SEPARATED BIRTHDATE: AGE: SEX: MALE
Co-pay assistance organizations offering assistance
Acromegaly Acute Exacerbations of Multiple Sclerosis Acute Porphyrias Advanced Idiopathic Parkinson' s Disease Age-Related Macular Degeneration www.theassistancefund.org Alcohol Dependence Alpha-1 Antitrypsin
Patient Information Form Pain Management Center at Phoebe
Patient Information Form Pain Management Center at Phoebe Please complete the following form, so that we may facilitate your visit Occupation: or (circle) Retired, Disabled Homemaker, Full time student
Informed Consent for Laparoscopic Vertical Sleeve Gastrectomy. Patient Name
Informed Consent for Laparoscopic Vertical Sleeve Gastrectomy Patient Name Please read this form carefully and ask about anything you may not understand. I consent to have a laparoscopic Vertical Sleeve
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:
Bile Duct Diseases and Problems
Bile Duct Diseases and Problems Introduction A bile duct is a tube that carries bile between the liver and gallbladder and the intestine. Bile is a substance made by the liver that helps with digestion.
Eger Eye Group, P.C.
Eger Eye Group, P.C. Last Name: Middle Initial: First Name: Birth Date: Street Address: City/State/Zip: Home Phone: ( ) Work Phone: ( ) Email: Occupation: Employer: Soc. Sec. #: Age: Sex: M F Race: Accompanied
800-475-6473. www.sjogrens.org. www.sjogrens.org
S j ö g r e n s F a s t F a c t s l The hallmark symptoms of Sjögren s syndrome are dry eyes and dry mouth. l Sjögren s is one of the most prevalent autoimmune disorders, striking as many as 4,000,000
What Each Vitamin & Mineral Does In Your Body. Vitamin A
What Each Vitamin & Mineral Does In Your Body Vitamin A Prevents skin disorders, such as acne, wrinkling and age spots. Enhances the immune system protects against colds, flu, and infections to kidney,
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
Reavis High School Anatomy and Physiology Curriculum Snapshot
Reavis High School Anatomy and Physiology Curriculum Snapshot Unit 1: Introduction to the Human Body 10 days As part of this unit, students will define anatomy, physiology, and pathology. They will identify
SUPER CARE CRITICAL ILLNESS PROTECTOR
SUPER CARE CRITICAL ILLNESS PROTECTOR At ACE Life, we are committed to helping our valued customers achieve financial security and have a peace of mind through our comprehensive range of life insurance
PATIENT REGISTRATION
PATIENT REGISTRATION Patient s Last Name: Patient s First Name: MI: Address: City, State Zip code: Patient s Date of Birth: Patient s Social Security: Best Number to contact: Secondary Number: Marital
2003 NCC Task Analysis Content Validation Study. Telephone Nursing Practice Examination
2003 NCC Task Analysis Content Validation Study Telephone Nursing Practice Examination Final Report NCC 645 N. Michigan #900 Chicago, IL 60611 312 951-0207 Study Table of Contents Background and Overview
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
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
IKHLASlink Comprehensive Critical Illness Benefit Secure Takaful Rider
IKHLASlink Comprehensive Critical Illness Benefit Secure Takaful Rider 1. IKHLASlink Comprehensive Critical Illness Benefit Secure Takaful Rider Securing life uncertainties. With IKHLASlink Comprehensive
412 Holistic Health, LLC Maura Schuster, L.OM 412.841.2065 Practitioner of Oriental Medicine NEW PATIENT INTAKE
412 Holistic Health, LLC Maura Schuster, L.OM 412.841.2065 Practitioner of Oriental Medicine NEW PATIENT INTAKE PATIENT INFORMATION Date Name Address City State Zip Age Birthdate Occupation Company name
MOUNT CARMEL RADIATION ONCOLOGY NEW PATIENT SELF HISTORY/SELF ASSESSMENT FORM. Reason for Consultation: Physicians involved in your care:
MOUNT CARMEL RADIATION ONCOLOGY NEW PATIENT SELF HISTORY/SELF ASSESSMENT FORM Name: Date: Reason for Consultation: Physicians involved in your care: PAST MEDICAL HISTORY HEAD, EYES, EARS CARDIOVASCULAR
6. Do you have an Advance Directive or Living Will? Yes No These are written statements about how you want to be treated if you get very sick.
Adult Health History Name: First Last Name you like to be called: Today s Date: Date of Birth: Male Female Transgender Male to Female Transgender Female to Male Other Filling out this form Answering these
New Jersey Department of Children and Families Policy Manual. Date: Chapter: C Case Management and Oversight Subchapter: 2 Services
New Jersey Department of Children and Families Policy Manual Manual: CP&P Child Protection and Permanency Effective Volume: III Case Management Date: Chapter: C Case Management and Oversight Subchapter:
COLORADO UNIFORM EMPLOYEE APPLICATION FOR SMALL GROUP HEALTH BENEFIT PLANS
COLORADO UNIFORM EMPLOYEE APPLICATION FOR SMALL GROUP HEALTH BENEFIT PLANS Employee Name: Proposed Effective Date: Group Number (if known): This form is designed for an employee s initial application for
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
Patient Guide. Important information for patients starting therapy with LEMTRADA (alemtuzumab)
Patient Guide Important information for patients starting therapy with LEMTRADA (alemtuzumab) This medicinal product is subject to additional monitoring. This will allow quick identification of new safety
ICD-9-CM/ICD-10-CM Codes for MNT
/ Codes for MNT ICD (International Classification of Diseases) codes are used by physicians and medical coders to assign medical diagnoses to individual patients. It is not within the scope of practice
Southwestern Foot & Ankle Associates, P.C. 3880 Parkwood Blvd, Suite 602 Frisco, TX 75034 Phone: 972-335-9071 Fax: 972-335-8920 Dr. Thomas H.
Phone: 972-335-9071 Fax: 972-335-8920 Date: Home Phone ( ) Patient Information (Please Print) Email: Name: SS/Patient ID # Last Name First Name Middle Initial Address Cell Phone ( ) City State Zip Sex
ANATOMY AND PHYSIOLOGY
ANATOMY AND PHYSIOLOGY Placement: First Year Theory - Anatomy: 60 Physiology: 60 Course Description -The course is designed to assist students to acquire the knowledge of the normal Structure of human
Medical conditions that preclude entry
Medical conditions that preclude entry If you have or have had any of the conditions listed below, it means that you do not meet the current medical standard required to enter RAF service: Eye disorders
X-Plain Low Testosterone Reference Summary
X-Plain Low Testosterone Reference Summary Introduction Testosterone is the most important male sex hormone. It helps the body produce and maintain adult male features. Low levels of testosterone affect
Overview. Geriatric Overview. Chapter 26. Geriatrics 9/11/2012
Chapter 26 Geriatrics Slide 1 Overview Trauma Common Medical Emergencies Special Considerations in the Elderly Medication Considerations Abuse and Neglect Expanding the Role of EMS Slide 2 Geriatric Overview
2ww Brain/CNS - Main Outpatients Department - Homerton - RQX. 2ww Haematology - Main Outpatients Department - Homerton - RQX
C&B Specialty C&B Clinic Types Service Name - 23rd April 2012 2WW Brain 2ww Brain/CNS - Main Outpatients Department - Homerton - RQX 2WW Breast 2ww Breast - Main Outpatients Department - Homerton - RQX
CRISIS COVER CLAIM FORM (DEAFNESS/ PARTIAL LOSS OF HEARING OR CAVERNOUS SINUS THROMBOSIS SURGERY/ COCHLEAR IMPLANT SURGERY) SECTION
Reg. No 199002477Z CRISIS COVER CLAIM FORM (DEAFNESS/ PARTIAL LOSS OF HEARING OR CAVERNOUS SINUS THROMBOSIS SURGERY/ COCHLEAR IMPLANT SURGERY) SECTION 1 This section is to be completed by the Life Assured
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
Mortality statistics and road traffic accidents in the UK
Mortality statistics and road traffic accidents in the UK An RAC Foundation Briefing Note for the UN Decade of Action for Road Safety In 2009 2,605 people died in road traffic accidents in the UK. While
ODM Care Management Excel File and Submission Specifications
ODM Care Management Excel File and Submission Specifications Issued: September 2013 1 Table of Contents 1. Introduction...3 2. HIPAA Security Measures...3 3. Care Management Certification Form.....3 4.
Patient Intake Form. Patient Information. How did you find out about our office?
Atlanta Injury and Wellness Center 2740 Greenbriar Parkway Suite A 3 Atlanta, GA 30331 404 629 9999 Patient Intake Form Welcome to our office of chiropractic. Thank you for taking a moment to fill in our
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,
MEDICAL EXAM QUESTIONNAIRE APPLICATION SUPPLEMENT
Hartford Life Insurance Company Hartford Life and Annuity Insurance Company MEDICAL EXAM QUESTIONNAIRE APPLICATION SUPPLEMENT INSTRUCTIONS FOR THE MEDICAL EXAMINER DETACH AND DISCARD BEFORE MAILING THE
Description Code Recommendation Description Code. All natural death 001-799 IPH All natural death A00-R99
Natural death Description Code Recommendation Description Code All natural death 001-799 IPH All natural death A00-R99 Infectious and parasitic diseases 001-139 CDC, EUROSTAT, CBS & VG Infectious and parasitic
PATIENT SELF-ASSESSMENT FORM
PATIENT SELF-ASSESSMENT FORM Please complete the information below to the best of your ability. Personal Information Name: Address: City: State: Zip: Telephone: Email: Name of referring physician: Address:
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
LIFE SETTLEMENT QUALIFIER
LIFE SETTLEMENT QUALIFIER D I R E C T SECTION 1 PRIMARY CONTACT Name _ Primary phone number ( ) Email Best time to call morning afternoon evening SECTION 2 POLICY DETAILS Life Insurance Policy Information
NCD for Lipids Testing
Applicable CPT Code(s): NCD for Lipids Testing 80061 Lipid panel 82465 Cholesterol, serum or whole blood, total 83700 Lipoprotein, blood; electrophoretic separation and quantitation 83701 Lipoprotein blood;
Health Information Form for Adults
A. IDENTIFICATION B. EMERGENCY CONTACTS Name (Last) (First) (Middle) Maiden Name Primary Alternate In Case of Emergency, Notify: Primary Contact Name (Last) (First) (Middle) Relationship Home Work Home
OrthoVirginia Registration Information 2016
OrthoVirginia Registration Information 2016 Patient Information Patient Name Account # Home Telephone # Work Telephone # Social Security Number Cell Telephone # Address Patient Sex Male Female City, State
WEIGHT LOSS SURGERY HEALTH QUESTIONNAIRE
WEIGHT LOSS SURGERY HEALTH QUESTIONNAIRE Patient Name: Date of Birth: The following information is very important to your health. Please take time to fully and completely fill out these forms. Important
CCS Statewide CY2012 Fee for Service Expenditures by Claim Type and Diagnosis Duplicate CIN Count Claim Type Code Desc DX Group DX SubGroup Sum of
CCS Statewide CY2012 Fee for Service Expenditures by Claim Type and Diagnosis Duplicate CIN Count Claim Type Code Desc DX Group DX SubGroup Sum of Medi-Cal Reimbursement * Outpatient Supplementary V Codes
It s not something you want to think about, but it s something you want to prepare for.
It s not something you want to think about, but it s something you want to prepare for. StemCyte cord blood banking offers your family a new lifesaving treatment alternative Why Bank Take the once-in-alifetime
Closed Sub-TOI: L08.000 Life - Other Co Tr Num: BANRD-01 State Status: Approved-Closed
Project Name/Number: / 01 Filing at a Glance Company: Banner Life Insurance Company SERFF Tr Num: FNBL-126416557 State: Arkansas TOI: L08 Life - Other SERFF Status: Closed-Approved- State Tr Num: 44441
Specialty Clinic Phone Listing
Adult Specialties Addiction Services (see Behavioral Health & Recovery/AODA) Allergy/Immunology 451 Junction Rd., Madison (West ) 263-6180 (local) 800-489-6008 (outreach clinics) 20 S. Park St., Madison