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OF INJURY/EXACERBATION PERTINENT PAST HISTORY Weight VITAL SIGNS Height N/A All WNL ROM Cervical spine /40 or limited Right Lat flex Left Lumbosacral spine /20 or Other ORTHO/NEURO/VASCULAR/VBI NA Therapies No Blood Pressure Temp Flexion /60 or limited Extension /50 or limited limited Rotation Left /80 or /90 or Extension /30 or WNL Please include location and intensity of findings. 427. 4777 All Other States Fax 877. 304. 2746 ASH TREATMENT FORM RECEIVED DATE ASH CLINICAL SERVICES MANAGER...
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dc clinicaltreatmentform 071609doc is a form used to document clinical treatment information in the District of Columbia.
Medical professionals and facilities providing clinical treatment services in the District of Columbia are required to file dc clinicaltreatmentform 071609doc.
dc clinicaltreatmentform 071609doc can be filled out by providing accurate and detailed clinical treatment information as per the form instructions.
The purpose of dc clinicaltreatmentform 071609doc is to document and report clinical treatment data for regulatory and monitoring purposes.
Information such as patient details, diagnosis, treatment provided, and other relevant clinical data must be reported on dc clinicaltreatmentform 071609doc.
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