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PRETREATMENT ASSESSMENT REPORT
I. IDENTIFYING INFORMATION
Name:
Parents:
Address:
Phone:XXX
Xxxix :
Date of Report:
Date of Birth:
Clinician:
Supervisor:Arabia (784.69)
2/10/2014
XXX
Sharon rose Jar
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Who needs apraxia 784?
01
Apraxia 784 is needed by individuals who have been diagnosed with apraxia, a motor speech disorder.
02
This form is used to gather information about the medical condition, symptoms, and relevant history of individuals affected by apraxia.
03
Doctors, speech-language pathologists, and other healthcare professionals may require this form to better understand the patient's condition and provide appropriate treatment and care.
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Family members or guardians of individuals with apraxia may also need to fill out this form to provide accurate information for the patient's medical records and treatment plans.
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What is apraxia 784?
Apraxia 784 is a type of motor disorder that impacts a person's ability to perform purposeful movements.
Who is required to file apraxia 784?
Individuals diagnosed with apraxia 784 or their caregivers are required to file apraxia 784 forms for documentation and treatment purposes.
How to fill out apraxia 784?
To fill out apraxia 784 forms, individuals need to provide detailed information about symptoms, diagnosis, treatment plan, and any other relevant details.
What is the purpose of apraxia 784?
The purpose of apraxia 784 forms is to document the presence and impact of the apraxia 784 motor disorder on individuals and to assist in creating an appropriate treatment plan.
What information must be reported on apraxia 784?
Information that must be reported on apraxia 784 forms include symptoms, diagnosis, treatment plan, healthcare providers involved, and any other relevant details.
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