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EMERGENCY DEPARTMENT SUPPLEMENTAL RECORD BACK PAIN PATIENTS NAME: DATE: AGE: SEX: M / VITAL SIGNS: A1 BP A3 P A4 R A5 T A6 HT Stated A7 WT Stated CC5 TIME OF PAIN ONSET: CC1 LOCATION OF PAIN: CC2

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What is back painpmd?

Back painpmd is a document used to report incidents of back pain at work.

Who is required to file back painpmd?

Employers are required to file back painpmd when an employee reports experiencing work-related back pain.

How to fill out back painpmd?

Back painpmd can be filled out by providing details of the employee, the incident, the severity of the pain, and any actions taken to address the issue.

What is the purpose of back painpmd?

The purpose of back painpmd is to track and address instances of work-related back pain to improve workplace safety.

What information must be reported on back painpmd?

Information such as the employee's name, date of the incident, description of the pain, and any corrective actions taken must be reported on back painpmd.

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