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Ceg progress note sheet ceg

“Medical Wellness & Life Balance” Client Name: _____________________________________________ Date: ____________ I am on the following medication: Birth Control_______________ Is there a Chance you are pregnant? _____ If on CARBATROL, TRILEPTAL, or DEPAKOTE and female, what birth control method do you use?_________________________________________________________________________________________________ Take HERBAL REMEDIES? Specify, ________________________________________________________________________ Vitamins? _______________________________________________________ ALLERGY SHOTS? ______________________ Do you have Mitral Valve Prolapse?_____________ LIST YOUR ALLERGIES: ___________________________________________________________ CURRENT MEDICATION you are taking (include meds you were taking on your last session here). List each medication and daily dosage.
1. _______________________________! ________! 2. _______________________________ !__________ 3. _______________________________! ________! 4. _______________________________! __________ 5. _______________________________! ________! 6. _______________________________! __________ New Medication since your last session. Please include over the counter medication: 1. _______________________________! __________! 2. _______________________________! __________ 3. _______________________________! __________4. _______________________________! Other doctors, psychologists, coaches, or ministers you have seen since your last session: ______________________________________________________________________________________________________________ ***Positive Changes in Your Life Since Last Session: ____________________________________________________ ______________________________________________________________________________________________________________ ***Challenges In Your Life Since Last Session: _________________________________________________________ ______________________________________________________________________________________________________________ ***Things I would like to discuss and or evaluate with the doctor, nurse, coach, or minister today: ______________________________________________________________________________________________________________ ______________________________________________________________________________________________________________ __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Return Date: _________________ Coach(es): _________________________________________ Date: _________________

Source: http://coreempowermentgroup.md/Forms_files/CEG-Progress%20Note%20Sheet_2.pdf

Wen-3018

Furosemide (10 mg/mL) Fliptop Vial AnsyrTM Plastic Syringe WARNING: Furosemide is a potent diuretic which, if given in excessive amounts, can lead to a profound diuresis with water and electrolyte depletion. Therefore, careful medical supervision is required and dose and dose schedule must be adjusted to the individual patient’s needs. (See DOSAGE AND ADMINISTRATION.) DES

L444-01(galera).p65

CASAMENTO SURPRESA DO ANO Opiniões divergentes em torno do romance explosivo entreastros de Hindenburg : casamento dos atores Bruno di Blasee Greta Woolston provoca a mídia. Tudo começou no set de Hindenburg , megalançamentodo ano passado que bateu recordes e conquistou seteestatuetas do Oscar, incluindo a de melhor filme. Apesar doromance entre os personagens heroicos na telona, o p

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