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  • Doctors Note Template 3

    Transféré par

    nipanipa
    117 vues1 page
    The document contains two sample doctors' notes. The first note is for a patient named Jane Doe who was diagnosed with a concussion and is not cleared to return to sports until further notice. The second note is for a patient named John Doe who was diagnosed with a left ankle sprain and is cleared to return to sports if he wears an ankle brace or has his ankle taped for practices and games. Both notes include the doctor's name, address, phone number, date, patient name, diagnosis, and restrictions or clearance, with the doctor's signature at the bottom.

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    The document contains two sample doctors' notes. The first note is for a patient named Jane Doe who was diagnosed with a concussion and is not cleared to return to sports until further notice. The second note is for a patient named John Doe who was diagnosed with a left ankle sprain and is cleared to return to sports if he wears an ankle brace or has his ankle taped for practices and games. Both notes include the doctor's name, address, phone number, date, patient name, diagnosis, and restrictions or clearance, with the doctor's signature at the bottom.

    Droits d'auteur :

    © All Rights Reserved
    Téléchargez comme PDF, TXT ou lisez en ligne sur Scribd
    Signaler comme contenu inapproprié
    117 vues1 page

    Doctors Note Template 3

    Transféré par

    nipanipa
    The document contains two sample doctors' notes. The first note is for a patient named Jane Doe who was diagnosed with a concussion and is not cleared to return to sports until further notice. The second note is for a patient named John Doe who was diagnosed with a left ankle sprain and is cleared to return to sports if he wears an ankle brace or has his ankle taped for practices and games. Both notes include the doctor's name, address, phone number, date, patient name, diagnosis, and restrictions or clearance, with the doctor's signature at the bottom.

    Droits d'auteur :

    © All Rights Reserved
    Téléchargez comme PDF, TXT ou lisez en ligne sur Scribd
    Signaler comme contenu inapproprié
    sur 1

    Examples of a Doctors Note

    Dr. Summit Falcon


    1780 Hawkins Rd.
    Fenton, MO 63026
    Phone: 555-555-5555
    Date: _________
    Patient Name: Jane Doe
    Diagnosis: Concussion
    Restricitions/Clearance:
    Jane is out of sports until further notice.
    Dr. Signature

    Dr. Summit Falcon


    1780 Hawkins Rd.
    Fenton, MO 63026
    Phone: 555-555-5555
    Date: _________
    Patient Name: John Doe
    Diagnosis: Left ankle sprain
    Restricitions/Clearance:
    John is able to return to sports but must wear an
    ankle brace or get taped for practices and games.
    Dr. Signature

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