韦斯特维尔儿童支持中心的病人表格

下载及列印病人表格

General Forms

下面是世界杯外围球庄在实践中经常使用的一般形式. 如果你对世界杯外围球庄的病人表格有任何疑问， please feel free to contact us.

2022-2023参赛前体能评估表(俄亥俄州高中体育协会)

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成人人口统计/登记表格

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Adult Health History Form

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财务责任协议表格

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信息发布授权

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在家登记预约

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综合初级保健+ (CPC+)信息

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未成年人阿片类药物处方同意书

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Consent to Photograph Form

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COVID-19 Info Sheet - Arabic

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COVID-19信息表-英文

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COVID-19 Info Sheet - French

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COVID-19 Info Sheet - Nepali

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COVID-19 Info Sheet - Somali

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COVID-19信息表-西班牙语

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指定他人同意治疗表格

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健康信息交换退出-成人

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健康信息交换撤回-儿科

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HIPAA隐私惯例通知

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New Adult Patient Forms

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New Pediatric Patient Forms

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家长/监护人对COVID-19疫苗的同意

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儿童人口统计/登记表格

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Pediatric Dosing Chart

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儿童健康史表格

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收到私隐实务通知

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要求对受保护健康信息(PHI)的披露进行会计处理

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要求修改受保护健康信息(PHI)表格

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限制受保护健康信息(PHI)表单的请求

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STARK通知-患者信息

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在患者门户网站和Healow应用程序上查看测试结果

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Advanced Directives Forms

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Cardiac Testing

Caffeine Information

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超声心动图信息

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心脏药物信息

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压力心电图信息

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Stress Echo Information

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Stress Test Only Information

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Diabetes Management

Africa Road Location Map

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伯特利里德公园位置图

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Medicare Patient Packet

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OSU Insurance Patient Packet

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其他保险病人资料包

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糖尿病管理-健康饮食变得简单

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糖尿病管理提示和信息

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糖尿病管理-什么是我的盘子所有关于信息图

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Fall Prevention

CDC STEADI工具包-预防跌倒清单

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练习-脚后跟脚趾抬高与反支撑

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锻炼——用扶手椅从坐到站

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练习-站立脚跟抬高，有支撑

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练习-站立串联平衡与反支撑

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Radiology (Imaging)

CT Abdomen - Pelvic

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CT Brain - Head

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CT冠状动脉钙化筛查(CACS)

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CT Enterography

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CT Extremities

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CT Neck

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CT Renal - Kidney Stone

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CT Sinus

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CT Spine

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DEXA Scan Preparation Sheet

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Ultrasound - Abdomen

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Ultrasound - Aorta Screening

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Ultrasound - Aorta

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Ultrasound - Carotid

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超声-膝关节(腘窝)

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Ultrasound - Lower Abdominal

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超声-下肢静脉

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Ultrasound - Renal (Kidney)

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Ultrasound - Renal Artery

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Ultrasound - Scrotum

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Ultrasound - Stress Arterial

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Ultrasound - Thyroid

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Physical Therapy

Balance Difficulties & Falls

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Cervical (Neck or Neck & Shoulder)

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Low Back & Sciatica

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Lower Extremity (Hip & Leg)

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上肢(肩、上臂至手)

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Vestibular (Dizziness)

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