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    PT - INR Flowsheet

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    brendacoon
    This document contains a patient's anticoagulation therapy record. It includes the patient's name, date of birth, contact information, the indication for anticoagulation such as atrial fibrillation or deep vein thrombosis, the start date and planned duration of therapy. The record tracks the date, current dose, PT/INR results, any complications, new dose if adjusted, next check date, and physician signature for each visit over the course of anticoagulation therapy.

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    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd

    PT - INR Flowsheet

    Uploaded by

    brendacoon
    1K views2 pages
    This document contains a patient's anticoagulation therapy record. It includes the patient's name, date of birth, contact information, the indication for anticoagulation such as atrial fibrillation or deep vein thrombosis, the start date and planned duration of therapy. The record tracks the date, current dose, PT/INR results, any complications, new dose if adjusted, next check date, and physician signature for each visit over the course of anticoagulation therapy.

    Original Title

    PT.INR Flowsheet

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    © Attribution Non-Commercial (BY-NC)

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    This document contains a patient's anticoagulation therapy record. It includes the patient's name, date of birth, contact information, the indication for anticoagulation such as atrial fibrillation or deep vein thrombosis, the start date and planned duration of therapy. The record tracks the date, current dose, PT/INR results, any complications, new dose if adjusted, next check date, and physician signature for each visit over the course of anticoagulation therapy.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    1K views2 pages

    PT - INR Flowsheet

    Uploaded by

    brendacoon
    This document contains a patient's anticoagulation therapy record. It includes the patient's name, date of birth, contact information, the indication for anticoagulation such as atrial fibrillation or deep vein thrombosis, the start date and planned duration of therapy. The record tracks the date, current dose, PT/INR results, any complications, new dose if adjusted, next check date, and physician signature for each visit over the course of anticoagulation therapy.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    of 2

    b

    Patient’s Name: _____________________________________ DOB: _____________________


    Contact Person: ________________________________ Contact #:
    ______________________
    Indication for anticoagulation therapy:
    Atrial fibrillation Deep Vein Thrombosis Mechanical valve
    Cerebrovascular accident Pulmonary embolism Other: _________________________
    Start date: _____/_____/_____ Therapy Duration: 3 months 6 months 1 year Indefinite Other: _______________

    Next INR
    Date Current Dose PT/INR Complications Initials New Dose Due MD Signature

    None Noted/Reported
    Lab Performed In-office

    None Noted/Reported
    Lab Performed In-office

    None Noted/Reported
    Lab Performed In-office

    None Noted/Reported
    Lab Performed In-office

    None Noted/Reported
    Lab Performed In-office

    None Noted/Reported
    Lab Performed In-office

    None Noted/Reported
    Lab Performed In-office

    None Noted/Reported
    Lab Performed In-office

    None Noted/Reported
    Lab Performed In-office

    None Noted/Reported
    Lab Performed In-office

    None Noted/Reported
    Lab Performed In-office

    None Noted/Reported
    Lab Performed In-office

    None Noted/Reported
    Lab Performed In-office

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