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  • Venice Family Clinic Chart Prep Checklist 2015

Get Venice Family Clinic Chart Prep Checklist 2015-2025

UPDATED: 1/30/15 CHART PREP CHECKLIST PROVIDER: Date: Patient Name Age Diagnostic.

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Bring your insurance cards and any forms you need filled out. Make a list of things you want to talk to your doctor about and take it with you. Make a list of all medicines (both prescription and over-the-counter) and vitamins/minerals you take. Write down the name, strength and how often you take it.

What not to do before a physical exam Consuming alcohol. Drinking caffeine within an hour of your visit. Eating a high-fat meal before bloodwork. Eating or drinking anything for eight to 12 hours, or as directed by your provider, before bloodwork that requires a fast. Taking cold medicine if you're feeling under the weather.

Venice Family Clinic was founded in 1970 by Philip Rossman, MD and Mayer B. Davidson, MD. Back then, volunteer physicians and other dedicated individuals provided basic medical care after normal business hours at the UCLA Dental Clinic on Lincoln Boulevard.

Give information about all your medications Make a list or bring everything with you to your visit—don't forget about eye drops, vitamins, and laxatives. Tell the doctor how often you take each. Describe any drug allergies or reactions you have had. Say which medications work best for you.

Let your doctor know if you are seeing other doctors or health care providers. Share information about any recent medical tests. Let your doctor know how much information you want and if you have religious or cultural beliefs that affect your treatment.

Include in your health record, whether digital or paper, the following information: Your name, age and sex. Your address. Your medication names, doses and schedules. Your medical equipment. Your chronic medical conditions, such as epilepsy. Medical consent form.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232