Form41 - FORM 41. Problem list for a problem-oriented...

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[ FORM 41 –Use the top of this page for your letterhead.] Problem List for a Problem-Oriented Record (POR) Client: Page #: Problems currently active Problems now inactive Problem number Date problem recognized Problem title/formulation Prob. # where problem is now included, or Date problem resolved This is a strictly confidential patient medical record. Redisclosure or transfer is expressly prohibited by law.
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Unformatted text preview: FORM 41. Problem list for a problem-oriented record (POR). From The Paper Office . Copyright 2008 by Edward L. Zuckerman. Permission to photocopy this form is granted to purchasers of this book for personal use only (see copyright page for details)....
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