Appendix A-2 Clinical Reminders at a Glance This is a worksheet to help track a clinic's selected reminders. See instructions on the following page. Make copies of this page for each clinic. Clinic___________________________________________________________ NCHP REMINDER GUIDELINE AMB CARE EP/SITE LOCAL SITE (* prefix) EXAMPLES DISTRIBUTED GUIDELINE ( prefix) A/I A/I A/I Breast Cancer Screen Mammogram Cervical Cancer Screen Pap Smear Cholesterol Screen (F) Cholesterol Screen (M) Colorectal Cancer Screen (FOBT) Fecal Occult Blood Test Colorectal Cancer Screen (Sig.) Flexisigmoidoscopy Fitness and Exercise Screen Exercise Education Hypertension Screen Blood Pressure Check Influenza Immunization Influenza Vaccine Pneumococcal Vaccine Pneumovax Problem Drinking Screen Alcohol Abuse Education Seat Belt and Accident Screen Seat Belt Education Tetanus Diptheria Immunization Tobacco Use Screen Tobacco Education Weight and Nutrition Screen Nutrition/Obesity Education Advanced Directives Education Breast Exam Breast Self Exam Education Digital Rectal (Prostate) Exam PPD PSA Weight **A/I=Active/Inactive Clinical Reminders at a Glance Worksheet Instructions Use the table on the previous page as a worksheet to help track a clinic's selected reminders. Each row of this table represents variations of the same type of reminder.
Appendix A-2 Clinical Reminders at a Glance This is a worksheet to help track a clinic's selected reminders. See instructions on the following page. Make copies of this page for each clinic. Clinic___________________________________________________________ NCHP REMINDER GUIDELINE (* prefix) A/I AMB CARE EP/SITE EXAMPLES DISTRIBUTED ( prefix) A/I LOCAL SITE GUIDELINE A/I Breast Cancer Screen Mammogram Cervical Cancer Screen Pap Smear Cholesterol Screen (F) Cholesterol Screen (M) Colorectal Cancer Screen (FOBT) Fecal Occult Blood Test Colorectal Cancer Screen (Sig.) Flexisigmoidoscopy Fitness and Exercise Screen Exercise Education Hypertension Screen Blood Pressure Check Influenza Immunization Influenza Vaccine Pneumococcal Vaccine Pneumovax Problem Drinking Screen Alcohol Abuse Education Seat Belt and Accident Screen Seat Belt Education Tetanus Diptheria Immunization Tobacco Use Screen Tobacco Education Weight and Nutrition Screen Nutrition/Obesity Education Advanced Directives Education Breast Exam Breast Self Exam Education Digital Rectal (Prostate) Exam PPD PSA Weight **A/I=Active/Inactive Clinical Reminders at a Glance Worksheet Instructions Use the table on the previous page as a worksheet to help track a clinic's selected reminders. Each row of this table represents variations of the same type of reminder.
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