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Suggestions for Performance Checklist with the LIFE PAK 12 Defibrillator/Monitor Monitoring Initial Carbon Dioxide (EtCO2) Name: Unit: Reviewer: Date: This Performance Checklist is a suggested assessment
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It is a form used for reporting physiotherapy services provided.
Physiotherapists who have provided services that require reporting.
The form should be completed with accurate information on the physiotherapy services provided.
The purpose is to accurately report physiotherapy services for billing and record-keeping purposes.
Information such as patient details, date of service, type of service provided, and fees charged must be reported.
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