He encontrado que alguna farmacia puede tener existencias limitadas de ciertos medicamentos, mientras que otras pueden tener casi cualquier formato que se le ocurra y el habitual de dosis habitualidad apareció. En resumen, siempre se contiene el almacén de corroborar. Al mismo tiempo que el producto que más que gustaba ha resultado no estaba disponible en stock otro distinto por las Buenas costumbres también debe buscarse jefe no asн parezca. Por eso es importante disponer de un Plan B para actuar cuandod ello no ocurra. Ventaja de tomar un genérico en lugar de Asix Un genérico es más barato que el nombre de marca Uno de los mayores incentivos para someterse al Dónde comprar Lasix genérico en lugar de pagar la marca es que usted puede obtener un ahorrando importantes Lasix genérico. Por lo tanto, un Lasix genérico es en general mucho más barato que el homólogo de marca, así que una denominación genérica se hace posible para las personas que usan este medicamento con frecuencia. Un ejemplo: La compra de lurosemida en lugar de Lasix es una considerable ahorro para el presupuesto mensual de medicamentos.

Collierville alzheimer’s day care center

Page Robbins Adult Day Care Center
Physician’s Form
(Note to Physician: The client and their caregiver below are completing an application for admission to Page
Robbins Adult Day Care Center. We provide day services to adults with dementia and/or who are frail. Please
complete this 3 page form and mail/fax it to our center or give to the primary caregiver. Thank you.)
General Information

______________________________________________ Street Address ______________________________________________ City and State ______________________________________________ Responsible Party/ Legal Guardian __________________________ Phone_______________ Height ______ Drug/Allergies _____________________________ Latex Allergy?______ (Please note that a chest XRay OR a Skin Test must have been completed within the last 6 months.)
Chest X-Ray: Yes_____No_____Date:________Results:_________________
PPD Skin Test: Yes_____No_____Date:________Results:_________________
Identification and Background Information

Last Medical Assessment Date ________________by______________________________
Bowel and Bladder:
Client has complete control of bowel and bladder
If No, Please Explain: _________________________________________________________ Client has one of the following: 1. External Catheter ______ 2. In-dwelling Catheter ______ 3. Pads, Briefs ______ 4. Ostomy (Please Specify) ______ 5. None ______ 6. Other ______ Client has been tested for a Urinary Tract Infection in the last 60 days Yes______No______ If Yes, Medication Prescribed: __________________________________________________ Page Robbins Adult Day Care Center Medical Form
Disease Diagnosis (Please check if yes)

Heart/Circulation
Arteriosclerotic Heart Disease
Other Cardiovascular Disease:________________
Neurological
Alzheimer’s disease
Other (Please specify) __________________________________________________________________
Pulmonary
Emphysema
Other: (Please specify) _________________________________________________________________
Psychiatric/Mood
Anxiety Disorder
Other: (Please specify): ________________________________________________________________
Vision

Other:
Anemia
7. Past Surgical History: ____________________________________________________________________ 8. Other Health Conditions: _________________________________________________________________ Page Robbins Adult Day Care Center Medical Form
Existing Conditions:
Constipation

Ambulation:
Independent
Please specify: ___________________________
Current Medications
(Please include: Name, Dosage, Frequency and Reason for Medication)
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
Non-Prescription Drugs (Given at the center PRN according to label if symptoms occur)
Tylenol 500 mg, 1 tab every 3-4hours

I certify that _____________________________________is free from Communicable Disease
Client’s Name)
and able to participate in an Adult Day Care Program.
_______________________________________ ___________________________
Physician (Please sign and Print Name) Date
_______________________________________
Physician Address Physician Phone Number Page Robbins Adult Day Care Center Medical Form

Source: http://pagerobbins.org/wp-content/uploads/Current-Physicians-Statement-Form-april-2011.pdf