Continuing Professional Development. Expanded Knowledge for Expanded Services

Size: px
Start display at page:

Download "Continuing Professional Development. Expanded Knowledge for Expanded Services"

Transcription

1 Continuing Professional Development Expanded Knowledge for Expanded Services

2 CPhA s Continuing Professional Development As your role expands, you need more advanced knowledge and skills to provide your patients with the best possible care. Our online, accredited, evidencebased continuing professional development programs can help you. Minor Ailments: New! Assessing and prescribing for minor ailments. Lab Tests: learn how to order, monitor and interpret lab test results to make better decisions for patient care. Medication Assessment and Management: it s more than just a list. Develop a systematic approach to assessing patients, documenting, developing care plans and more. QUIT: enhance your skills, confidence and ability to provide smoking cessation services. CANRISK: develop your ability to screen, interpret and communicate your patients risk of diabetes with this validated tool. FIND OUT MORE:

3 Minor Ailments CE Assessing and Prescribing for Minor Ailments Pharmacists can now prescribe for certain minor ailments in most provinces. Be prepared learn how to assess and treat more than 30 conditions, covering the full range of minor ailments for which authority has been extended. This new series of 28 educational modules is a self-directed online program that uses patient cases to help translate theory into practice. Each module covers: Patient assessment Differential diagnosis Modules: Acne vulgaris Allergic rhinitis nasal congestion Aphthous ulcers (canker sores) Atopic dermatitis Calluses and corns Candidal stomatitis (oral thrush) Cough and sore throat Diaper dermatitis When to refer Treatment alternatives (including prescription drugs) Diarrhea (non-infectious) Dry eye, red eye and minor eye infections Dysmenorrhea Emergency contraception GERD and dyspepsia Hemorrhoids Herpes simplex Impetigo Insomnia Mild headache Treatment algorithms Monitoring and follow-up Musculoskeletal pain Nausea and vomiting Pinworms Seborrheic dermatitis Superficial fungal skin infections Urinary tract infection Urticaria (insect bites and stings) Vaginal candidiasis Warts Learning schedule: Participants purchase the entire program at once then work through it at their own pace. Pharmacy association members: $750 plus tax Regular price: $1250 plus tax In partnership with

4 LAB TESTS Ordering, Monitoring and Interpreting Laboratory Tests to Optimize Medication Management Lab Tests is a certificate course that highlights the main lab results that illustrate the need for, or are affected by, drug therapy. Supplemented by case studies, the course is designed as a practical program to quickly bring pharmacists up to speed in ordering and monitoring lab results. Lab Tests shows you how to: Define basic terms describing aspects of laboratory testing such as specificity, sensitivity, precision, etc. Become familiar with common lab tests looking at electrolytes, kidney function, liver function, endocrine and lipids, and hematology Identify situations in which a lab test would be a reasonable step to monitor a patient without causing undue burden on the patient or the health care system Determine if lab values are within a reference range Identify drugs that could be contributing to abnormal lab results Identify the expected outcome of initiating medications on lab results Use lab results to guide therapeutic choices Be aware of how the assessment of lab values can enhance the provision of expanded scope services such as medication reviews, pharmaceutical opinions and prescription adaptation Learning schedule: Lab Tests is available online and registrants work at their own pace to complete the CEU course. Pharmacy association members: $249 plus tax Regular price: $299 plus tax

5 MEDICATION ASSESSMENT AND MANAGEMENT Providing Effective Medication Review Services in Your Community Pharmacy (formerly Medication Review Services) A medication review is so much more than just a list! It can be your first step in developing an ongoing relationship with your patients and their prescribers. Learn how to provide high-quality medication review services in your daily practice. Medication Assessment and Management shows you how to: Initiate conversations with patients Use a systemic approach to assess medications Document interactions, care and monitoring plans Communicate recommendations to physicians 89% of community pharmacists who completed this program said they will increase the number of medication reviews they provide (n = 587) 98% said the quality of their services will improve (n = 587) The online CE certificate program includes: Province-specific requirements & templates for reimbursement Practical exercises, knowledge and processes An online, self-directed customized learning experience Learning schedule: Medication Assessment and Management is available online and registrants work at their own pace to complete the 8 CEU course. Pharmacy association members: $149 plus tax Regular price: $179 plus tax 8

6 QUIT SMO Smoking Cessation Program Help your patients quit with our smoking cessation program. Whether you need a refresher on nicotine replacement therapies and other smoking cessation aids, or want to perfect your patient care skills in smoking cessation counselling and care planning, this 5-CEU online program will enhance your skills, confidence and ability to provide smoking cessation services. QUIT shows you how to: Start intervention and counsel patients Recognize the effects of nicotine and identify levels of dependence Identify cessation methods and determine the most appropriate course of action in different situations Create a smoking cessation program in your pharmacy NEW: e-cigarettes, new pharmacotherapy data, provincial updates and more Pharmacy association members: $99 plus tax Regular price: $119 plus tax 5 CANRISK DIABETES CE Using the CANRISK Diabetes Risk Questionnaire in Your Community Pharmacy CANRISK CE shows you how to: Interpret a patient s risk for pre-diabetes and diabetes according to the results of the CANRISK questionnaire and communicate these results in a manner that is clearly understood by the patient Recommend appropriate lifestyle modification strategies for patients with pre-diabetes and diabetes and encourage effective diabetes prevention and self-management Plan and implement strategies to incorporate the use of the CANRISK questionnaire into routine pharmacy practice and recognize opportunities for linking CANRISK screening to paid professional services Pharmacy association members: $25 plus tax Regular price: $30 plus tax 3

7 HEAR WHAT PEOPLE ARE SAYING ABOUT OUR PROGRAMS: Medication Assessment and Management The process you learn of detailing the drug therapy problems, goals of therapy, intervention/plan, collaboration and responsibilities, ensures nothing is missing plus a different pharmacist can easily follow up... I have used what I learned in this course with other pharmacists to outline possible missing information or streamline their med reviews. Jacalyn Swindlehurst, BScPharm, Drayton Valley, AB Lab Tests Lab Tests helps us as pharmacists see a bigger picture of patients health and how effective their medications might be, along with helping to detect earlier if their meds are causing issues or their disease state is progressing. It also gives us a better understanding of adjusting doses in liver or renal failure. Janice Dillman, BScPharm, community pharmacist, Cole Harbour, NS QUIT Smoking Cessation I found that keeping up with the forever changing pharmacy environment has become increasingly more difficult. Taking programs like CPhA s QUIT have been integral in structuring my own ability to handle these changes. Kristine Petrasko, Regional Pulmonary Educator, MB

8 FIND OUT MORE: The Canadian Pharmacists Association is accredited as a provider by the Canadian Council on Continuing Education in Pharmacy with a commendation for leadership in continuing pharmacy education. Approved Accredited Providers may accredit their own programs using CCCEP guidelines and criteria. Accredited Providers use the Accredited Provider logo to indicate that their program is CCCEP accredited. Course authors, learning objectives and accreditation information can be found online for each program.

Minor Ailment definitions From the list in Appendix 2 of the Regulations

Minor Ailment definitions From the list in Appendix 2 of the Regulations Minor Ailment definitions From the list in Appendix 2 of the Regulations Contents Allergic Rhinitis... 2 Calluses and Corns... 2 Contact Allergic Dermatitis... 2 Dandruff... 2 Dysmenorrhea... 2 Dyspepsia...

More information

Pharmacy Prep. Qualifying Pharmacy Review

Pharmacy Prep. Qualifying Pharmacy Review Pharmacy Prep 2014 Misbah Biabani, Ph.D Director, Tips Review Centres 5460 Yonge St. Suites 209 & 210 Toronto ON M2N 6K7, Canada Luay Petros, R.Ph Pharmacy Manager, Wal-Mart, Canada 1 Disclaimer Your use

More information

Prescribing medicine for minor illnesses. Consultation. Information booklet

Prescribing medicine for minor illnesses. Consultation. Information booklet Prescribing medicine for minor illnesses Consultation Information booklet Every year, there are a lot of GP appointments for illnesses people can treat by themselves, without having to see a doctor. People

More information

ALASKA COMMUNITY HEALTH AIDE PROGRAM Standing Orders-January CHA/P Name: Village:

ALASKA COMMUNITY HEALTH AIDE PROGRAM Standing Orders-January CHA/P Name: Village: CHA/P Name: Village: Tribal Health Organization: is authorized to treat patients with the Alaska Community Health Aide/Practitioner Manual (echam) ASSESSMENTS that are initialed below according to the

More information

MINOR AILMENT PRESCRIBING IN SASKATCHEWAN. Jahnaya Mann, BSP Erin Read, BSP Leah Perrault, BSP Pharmasave Swift Current, Sk

MINOR AILMENT PRESCRIBING IN SASKATCHEWAN. Jahnaya Mann, BSP Erin Read, BSP Leah Perrault, BSP Pharmasave Swift Current, Sk MINOR AILMENT PRESCRIBING IN SASKATCHEWAN Jahnaya Mann, BSP Erin Read, BSP Leah Perrault, BSP Pharmasave Swift Current, Sk HISTORY OF PRESCRIBING IN SK First province in the country to be remunerated for

More information

CPhA PRE-BUDGET CONSULTATION BRIEF Prescriptions for a healthy and productive Canada

CPhA PRE-BUDGET CONSULTATION BRIEF Prescriptions for a healthy and productive Canada CPhA PRE-BUDGET CONSULTATION BRIEF 2018 Prescriptions for a healthy and productive Canada Introduction On behalf of the Canadian Pharmacists Association (CPhA) and Canada s 40,000 pharmacists, we are pleased

More information

Please have your health insurance card(s), a valid picture ID, and any applicable copayment ready when you check-in.

Please have your health insurance card(s), a valid picture ID, and any applicable copayment ready when you check-in. Please have your health insurance card(s), a valid picture ID, and any applicable copayment ready when you check-in. We have enclosed a questionnaire for you to complete and bring to the visit. Please

More information

Prescribing of over the counter medicines is changing

Prescribing of over the counter medicines is changing Prescribing of over the counter medicines is changing NHS England held a consultation on some changes to prescribing medication you can buy over the counter. This medication can be bought over the counter

More information

Response ID ANON-788X-RE3D-D

Response ID ANON-788X-RE3D-D Response ID ANON-788X-RE3D-D Submitted to Conditions for which over the counter items should not routinely be prescribed in primary care: A consultation on guidance for CCGs Submitted on 2018-03-13 15:11:25

More information

self care what is self care? caring a pack to start conversations... THE NHS SAYS But can it mean more? mental wellbeing minor ailments

self care what is self care? caring a pack to start conversations... THE NHS SAYS But can it mean more? mental wellbeing minor ailments self care In Dudley borough mental wellbeing what is self care? THE NHS SAYS minor ailments long term conditions caring role of professionals Self care is about keeping fit and healthy, understanding when

More information

Dispensing of Nicotine Replacement Therapy (NRT)

Dispensing of Nicotine Replacement Therapy (NRT) Simcoe Muskoka District Health Unit Print Version Medical Directive Number: Topic: Dispensing of Nicotine Replacement Therapy (NRT) Revised: October 2011 Approved: May 21, 2007 Description Nicotine Replacement

More information

Pharmacotherapy Handbook

Pharmacotherapy Handbook Pharmacotherapy Handbook Eighth Edition Barbara G. Wells, PharmD, HP, FCCP, BCPP Dean and Professor Executive Director, Research Institute of Pharmaceutical Sciences School of Pharmacy, The University

More information

Northeast Ohio Urogynecology Patient History Intake Form. Last Name First Name Age. Date of Birth Race Referring Physician.

Northeast Ohio Urogynecology Patient History Intake Form. Last Name First Name Age. Date of Birth Race Referring Physician. Northeast Ohio Urogynecology Patient History Intake Form Last Name _First Name Age_ Date of Birth Race Referring Physician Reason for Visit: _ Allergies: Preferred Lab (circle): QUEST LABCARE PLUS LABCORP

More information

The Food Intolerance Institute of Australia

The Food Intolerance Institute of Australia The Intolerance Institute of Australia The Symptoms Matrix The Symptoms Matrix allows you to narrow the possibilities of your food rather than diagnose it. To get an accurate identification of your food

More information

Newfoundland and Labrador Pharmacy Board Standards of Practice

Newfoundland and Labrador Pharmacy Board Standards of Practice Newfoundland and Labrador Pharmacy Board Standards of Practice Standards for the Safe and Effective Administration of Drug Therapy by Inhalation or Injection June 2015 Table of Contents 1) Introduction...

More information

Functional Blood Chemistry & CBC Analysis

Functional Blood Chemistry & CBC Analysis Functional Blood Chemistry & CBC Analysis Session 11 Immune Markers Immune Dysfunctions Immune Deficiency, Allergies, Immune Over Activity Causes of Immune Dysregulation External Influences Pharmaceutical

More information

Collaborative community Offsite Pharmacy Practice Phase 1 Kinburn Pharmasave Mahone Bay, Nova Scotia

Collaborative community Offsite Pharmacy Practice Phase 1 Kinburn Pharmasave Mahone Bay, Nova Scotia Collaborative community Offsite Pharmacy Practice Phase 1 Kinburn Pharmasave Mahone Bay, Nova Scotia Susan Beresford BScPharm Jennine Crawshaw BScPharm Lisa Zwicker BScPharm ADAPT Moderator Consultant

More information

21st century community pharmacy

21st century community pharmacy From dispensing and counseling to patient care (?) 21st century community pharmacy Saija Leikola Development manager, PhD Pharmac Finland Oy WHAT WE DO NOW? Dispense Counsel, give instructions, check DDIs

More information

The 5A's are practice guidelines on tobacco use prevention and cessation treatment (4):

The 5A's are practice guidelines on tobacco use prevention and cessation treatment (4): Smoking Cessation Module Tobacco use is the single greatest preventable cause of chronic diseases and premature deaths worldwide. The Canadian Cancer Society reports that tobacco product use is responsible

More information

Public Dissemination Effective: January 2018

Public Dissemination Effective: January 2018 Board of Pharmacy Specialties Board Certified Geriatric Pharmacist (BCGP) Detailed Content Outline 1. GENERAL PRINCIPLES OF AGING (20%) A. Apply the knowledge of physiologic changes associated with aging

More information

1

1 1 2 3 4 5 6 Scratch and Sniff All About Allergies Doug Jones, MD Program Director, Family Medicine, DHMG What is an allergic reaction? The immune system identifies things that are foreign and protects

More information

2. Have your symptoms affected your ability to carry out your daily activities? YES NO

2. Have your symptoms affected your ability to carry out your daily activities? YES NO QUESTIONNAIRE Page 1 of 5 Date: Referring MD (Name, Address, Phone Number): Primary Care Physician (Name and Address, Phone Number): Reason for visit: 1. How long have you had symptoms? Describe your symptoms?

More information

Evaluating Exam Review Book and Guide

Evaluating Exam Review Book and Guide Pharmacy Prep Evaluating Exam Review Book and Guide Misbah Biabani, Ph.D Director Toronto Institute of Pharmaceutical Sciences (TIPS) Inc. Toronto, ON M2N 6K7 Pharmacy Prep Professional Exams Preparation

More information

Enquiry Severity Immediate or other. Joint or muscle pain - any part of the body. Abdominal pain Acute Non-acute. Acne Anxiety Acute Non-acute

Enquiry Severity Immediate or other. Joint or muscle pain - any part of the body. Abdominal pain Acute Non-acute. Acne Anxiety Acute Non-acute We operate a hybrid triage system offering a mixture of telephone consultations, on the day emergency consultations with a doctor or pre bookable (3 days in advance) GP / Nurse Practitioner appointments

More information

How does my new treatment work?

How does my new treatment work? How does my new treatment work? Get to know KEVZARA better. Click here for full Prescribing Information including 1 risk of SERIOUS SIDE EFFECTS and Medication Guide. You're starting KEVZARA... GOT A QUESTION?

More information

What are my treatment support resources?

What are my treatment support resources? What are my treatment support resources? Get help when you need it. Click here for full Prescribing Information including risk of SERIOUS SIDE EFFECTS and Medication Guide. We re here to help you......

More information

PHARMACISTS IN CANADA

PHARMACISTS IN CANADA PHARMACISTS IN CANADA A national survey of Canadians on their perceptions and attitudes towards pharmacists. February 2017 Research conducted by: David Coletto METHODOLOGY Online survey Survey was conducted

More information

Hertfordshire and West Essex Sustainability and Transformation Partnership. Welcome

Hertfordshire and West Essex Sustainability and Transformation Partnership. Welcome Welcome What is an STP? Herts Valleys CCG, East and North Hertfordshire CCG and West Essex CCG working together with county and district councils The challenges we face Prioritising health services in

More information

ANNUAL INFLUENZA IMMUNIZATION POLICY

ANNUAL INFLUENZA IMMUNIZATION POLICY 1.0 POLICY The Chief Public Health Office (CPHO), Department of Health and Wellness (HW), will make available influenza vaccine free of charge annually to Islanders over 6 months of age as part of the

More information

Treating minor conditions

Treating minor conditions Treating minor conditions Think Pharmacist THE BEST OF HEALTH FOR WEST SUFFOLK Treating minor conditions Minor conditions are generally not a serious health problem and can be treated with Over The Counter

More information

Evidence-Based Clinical Practice Guideline. Treatment & Management of Ocular Disease

Evidence-Based Clinical Practice Guideline. Treatment & Management of Ocular Disease Evidence-Based Clinical Practice Guideline Treatment & Management of Ocular Disease Effective November 29, 2017 Treatment & Management Of Ocular Disease Clinical Practice Guideline The objective of this

More information

Brighton and Hove Pharmacy Enhanced Service (PLES 02)

Brighton and Hove Pharmacy Enhanced Service (PLES 02) Brighton and Hove Pharmacy Enhanced Service (PLES 02) Smoking Cessation Service (2007/08) This enhanced service is aimed at clients who are non-complex cases and would like to be supported and be managed

More information

Scope and Methodology Size and Growth of the Market Issues and Trends Affecting the Rx-to-OTC Switches Market Leading Competitors

Scope and Methodology Size and Growth of the Market Issues and Trends Affecting the Rx-to-OTC Switches Market Leading Competitors TABLE OF CONTENTS CHAPTER ONE: EXECUTIVE SUMMARY Scope and Methodology Size and Growth of the Market Issues and Trends Affecting the Rx-to-OTC Switches Market Leading Competitors CHAPTER TWO: INTRODUCTION

More information

Proposed changes to prescribing in Croydon. Lambeth. NHS prescriptions in Lambeth

Proposed changes to prescribing in Croydon. Lambeth. NHS prescriptions in Lambeth Proposed changes to prescribing in Croydon Lambeth NHS prescriptions in Lambeth 1 NHS Lambeth Clinical Commissioning Group 1. Introduction We are seeking your views on our proposals to make some changes

More information

BACK TO BASICS HEALTH & NUTRITION COMPREHENSIVE HEALTH HISTORY

BACK TO BASICS HEALTH & NUTRITION COMPREHENSIVE HEALTH HISTORY BACK TO BASICS HEALTH & NUTRITION COMPREHENSIVE HEALTH HISTORY Thank you for choosing Back To Basics Health & Nutrition to assist you with your natural health care. The ability to draw effective conclusions

More information

DNA CENTER New Patient Information

DNA CENTER New Patient Information DNA CENTER New Patient Information Name Email: Address City State Zip Home Phone Work Cell Phone Social Security Number Date of birth Gender ( Male/Female) Age Please Circle: Hispanic/Latin or Non Hispanic/Latin

More information

REGIONAL PHARMACY SPECIALIST SMOKING CESSATION SERVICE FEBRUARY A Pharmacist s Guide

REGIONAL PHARMACY SPECIALIST SMOKING CESSATION SERVICE FEBRUARY A Pharmacist s Guide REGIONAL PHARMACY SPECIALIST SMOKING CESSATION SERVICE FEBRUARY 2009 A Pharmacist s Guide Aims of the Service The overall aim of the service is to deliver a pharmacy based, one stop specialist smoking

More information

Where is your pain located? Please use the diagram below to indicate where most of your pain is located.

Where is your pain located? Please use the diagram below to indicate where most of your pain is located. Name: Address: Social Security Number: Email Address: Emergency Contact: Primary Care Physician: Name: Address: Phone Number: Date of Birth: Today's date: Cell Phone Number: Phone #: Referring Physician:

More information

TEACH: Training practitioners in smoking cessation counselling

TEACH: Training practitioners in smoking cessation counselling TEACH: Training practitioners in smoking cessation counselling Treatments to help people quit smoking are among the most cost-effective ways to reduce the risk of disease or death. The likelihood of quitting

More information

GASTROENTEROLOGY PATIENT QUESTIONNAIRE - PLEASE PRINT

GASTROENTEROLOGY PATIENT QUESTIONNAIRE - PLEASE PRINT GASTROENTEROLOGY PATIENT QUESTIONNAIRE - PLEASE PRINT Full name: Date: Telephone Number: Age: Address: Email address: CHIEF COMPLAINTS(List the problems about which you came to see the doctor) 1) 2) 3)

More information

l.com The gy or foodintol COPYRIGHT: Copyright of the

l.com  The gy or foodintol COPYRIGHT: Copyright of the The Symptoms Matrix Symptoms of Food Allerg gy or Food Intolerance foodintol : The foodintol Trademark is a Registered Trademark of No Whey Pty Ltd ABN 37 644 931 517 COPYRIGHT: All publications are protected

More information

GOALS FOR THE PRIMARY CARE CLERKSHIP

GOALS FOR THE PRIMARY CARE CLERKSHIP GOALS FOR THE PRIMARY CARE CLERKSHIP GOALS - The goal of the Third Year Primary Care clerkship is intended as a brief, but intensive, introduction to the world of the generalist physician. These four weeks

More information

CONSULATION ON ITEMS WHICH SHOULD NOT BE ROUTINELY PRESCRIBED IN PRIMARY CARE FREQUENTLY ASKED QUESTIONS

CONSULATION ON ITEMS WHICH SHOULD NOT BE ROUTINELY PRESCRIBED IN PRIMARY CARE FREQUENTLY ASKED QUESTIONS CONSULATION ON ITEMS WHICH SHOULD NOT BE ROUTINELY PRESCRIBED IN PRIMARY CARE FREQUENTLY ASKED QUESTIONS Consultation content: 18 products Patient experience Savings Working group Over-the-counter medicines

More information

Corinna Mosher, M.D. A Medical Corporation 415 E. Rolling Oaks Drive Suite #280 Thousand Oaks, CA (805) Fax (805)

Corinna Mosher, M.D. A Medical Corporation 415 E. Rolling Oaks Drive Suite #280 Thousand Oaks, CA (805) Fax (805) Patient Registration: Corinna Mosher, M.D. A Medical Corporation 415 E. Rolling Oaks Drive Suite #280 Thousand Oaks, CA 91361 (805) 496-8522 Fax (805) 496-0469 Last Name: First Name: MI: Address: City:

More information

All medicines have risks and benefits. Your doctor has weighed the risks of you taking Triprim against the benefits he or she expects it will have.

All medicines have risks and benefits. Your doctor has weighed the risks of you taking Triprim against the benefits he or she expects it will have. Triprim Tablets Trimethoprim Tablets Consumer Medicine Information What is in this leaflet? The leaflet answers some common questions about Triprim tablets. It does not contain all the available information

More information

ISSUING AGENCY: Regulation and Licensing Department - Board of Pharmacy, Albuquerque, NM. [ NMAC - N, ; A, ]

ISSUING AGENCY: Regulation and Licensing Department - Board of Pharmacy, Albuquerque, NM. [ NMAC - N, ; A, ] TITLE 16 CHAPTER 19 PART 26 OCCUPATIONAL AND PROFESSIONAL LICENSING PHARMACISTS PHARMACIST PRESCRIPTIVE AUTHORITY 16.19.26.1 ISSUING AGENCY: Regulation and Licensing Department - Board of Pharmacy, Albuquerque,

More information

DOB: / / Please list the names and telephone numbers of the other physicians involved in your care: Name Specialty Phone Address Receive Report (Y/N)

DOB: / / Please list the names and telephone numbers of the other physicians involved in your care: Name Specialty Phone Address Receive Report (Y/N) Medical History: Patient: DOB: / / Please list the names and telephone numbers of the other physicians involved in your care: Name Specialty Phone Address Receive Report (Y/N) List the names of prescription

More information

Honduras New Hope Clinic Weekly Reports, August Weekly Report August 3-7, 2015

Honduras New Hope Clinic Weekly Reports, August Weekly Report August 3-7, 2015 Honduras New Hope Clinic Weekly Reports, August 2015 Weekly Report August 3-7, 2015 This week we saw a total of 82 patients, 35 of whom were unable to pay because of limited financial This a 32 year old

More information

CLINIC. Frequently Asked Questions

CLINIC. Frequently Asked Questions About Target Clinic 1. How is Target Clinic different from a regular urgent care clinic? Target Clinic is a convenience-care clinic. Our medical professionals can diagnose and treat illnesses, minor injuries

More information

GROUP 15 TOPICAL PREPARATIONS

GROUP 15 TOPICAL PREPARATIONS - 105 - GROUP 15 15.1 DERMATOLOGICAL PREPARATIONS 15.1.1 TOPICAL ANTIFUNGALS CLOTRIMAZOLE Indication: Treatment of susceptible fungal infections, dermatophytoses, superficial mycoses, and cutaneous candidiasis

More information

A. Please include any medications (herbal, prescription, or Over-the-counter) and any supplements that you are currently taking.

A. Please include any medications (herbal, prescription, or Over-the-counter) and any supplements that you are currently taking. New Patient Questionnaire Please complete this and bring it with you to your visit. If you have it completed five days or more prior to your visit, please mail or fax it to our office. Most recent treating

More information

Patient Intake Form for Allegany Ear, Nose, & Throat

Patient Intake Form for Allegany Ear, Nose, & Throat Patient Intake Form for Allegany Ear, se, & Throat Patient Name: What brings you to the office today? Who is your primary care doctor? Please list your current medications: Are you allergic to any medications?

More information

Prince Edward Island Chronic Obstructive Pulmonary Disease (COPD) Trends

Prince Edward Island Chronic Obstructive Pulmonary Disease (COPD) Trends Prince Edward Island Chronic Obstructive Pulmonary Disease (COPD) Trends 2001-2011 December 2014 Population Health Assessment and Surveillance Unit, Chief Public Health Office, Department of Health and

More information

Helping People Quit Tobacco

Helping People Quit Tobacco Helping People Quit Tobacco Peter Selby MBBS, CCFP, MHSc, ASAM Associate Professor, University of Toronto Clinical Director, Addictions Program, CAMH Principal Investigator, OTRU Disclosures! Grants/research

More information

The NHS Minor Ailment Service at your local pharmacy

The NHS Minor Ailment Service at your local pharmacy The NHS Minor Ailment Service at your local pharmacy ADVICE Information for patients What is the NHS Minor Ailment Service? TheMinorAilmentServiceisanNHSserviceforchildren, peopleaged60orover,peoplewhoholdamedical

More information

PULMONARY CARE OF CENTRAL FLORIDA, P.A. Date: / /

PULMONARY CARE OF CENTRAL FLORIDA, P.A. Date: / / PULMONARY CARE OF CENTRAL FLORIDA, P.A. Date: / / Patient Name Age DOB: / / Family Physician Referring Physician Telephone Number Telephone Number Pharmacy: Phone: Fax: MEDICAL HISTORY 1. What is your

More information

NURSING PROCESS FOCUS: Patients Receiving Amphotericin B (Fungizone, Abelcet)

NURSING PROCESS FOCUS: Patients Receiving Amphotericin B (Fungizone, Abelcet) NURSING PROCESS FOCUS: Patients Receiving Amphotericin B (Fungizone, Abelcet) ASSESSMENT Prior to administration: Obtain complete health history including allergies, drug history, and possible drug interactions.

More information

Creve Coeur Family Medicine, LLC

Creve Coeur Family Medicine, LLC Creve Coeur Family Medicine, LLC Patient Name: Date of Birth: Medication List Medication Name (Over the counter medications too) Strength/ Dose (mg) Number of pills per dose Number of times per day Personal

More information

Medical History Form

Medical History Form Medical History Form Full Name Title: Mr/Mrs/Ms/Miss Address Date of Birth Date Telephone: Mobile: Email: How did you hear about the Garden of health? G.P s Name and Address Are you currently seeing your

More information

CAPhO Oncology Fundamentals Day Saturday, October 1, 2016

CAPhO Oncology Fundamentals Day Saturday, October 1, 2016 The Canadian Association of Pharmacy in Oncology Presents CAPhO Oncology Fundamentals Day www.capho.org #OFD16 www.acpho.org [Type here] Accreditation CAPhO Oncology Fundamentals Day is accredited by the

More information

Ayurvedic Intake Form

Ayurvedic Intake Form Ayurvedic Intake Form Name: Today s Date Date of birth: Time of birth: Place of birth: Place of childhood: Other Places lived: Current address: Home phone: Work phone: Email address: Occupation: Age: Sex:

More information

Comprehensive COPD Program Outline

Comprehensive COPD Program Outline Comprehensive COPD Program Outline Introduction The Comprehensive COPD Program offered by Pear Healthcare Solutions Inc. has been developed for healthcare professionals who wish to develop their knowledge

More information

EMERGENCY SCREENING PLEASE PROVIDE US THE REASON FOR YOUR VISIT TODAY. Date of Birth: Is today s visit related to work place injury?

EMERGENCY SCREENING PLEASE PROVIDE US THE REASON FOR YOUR VISIT TODAY. Date of Birth: Is today s visit related to work place injury? EMERGENCY SCREENING Welcome to MedStar PromptCare. In order to provide the very best care for you and also protect your privacy, we ask that you complete this form immediately upon presentation to the

More information

This week we saw a total of 85 patients, 25 of whom were unable to pay because of limited financial resources.

This week we saw a total of 85 patients, 25 of whom were unable to pay because of limited financial resources. February 2014 Honduras New Hope Clinic Weekly Reports Weekly Report Feb. 3-7, 2014 This week we saw a total of 85 patients, 25 of whom were unable to pay because of limited This week the clinic donated

More information

THE REGIONAL MUNICIPALITY OF NIAGARA REQUEST FOR PRE-QUALIFICATION (RFPQ) OF

THE REGIONAL MUNICIPALITY OF NIAGARA REQUEST FOR PRE-QUALIFICATION (RFPQ) OF THE REGIONAL MUNICIPALITY OF NIAGARA REQUEST FOR PRE-QUALIFICATION (RFPQ) OF CESSATION SUPPORT AND NICOTINE REPLACEMENT THERAPY TO RESIDENTS IN THE COMMUNITY DOCUMENT NUMBER# ISSUE DATE: WEDNESDAY OCTOBER

More information

Cardiovascular Consent Form

Cardiovascular Consent Form Cardiovascular Consent Form Dear Primary Care Provider, A patient currently under your care for a cardiovascular condition has come to the Kingsbury Club Therapy Center to receive a therapeutic massage.

More information

Smoking cessation therapy

Smoking cessation therapy Appendix 1 Smoking cessation therapy Q. Can a dentist prescribe medications for smoking cessation? A. Yes. Dentists are allowed and are encouraged to help patients with smoking cessation by counseling

More information

RE: CONSULTATION ON DRAFT - DRUG AND NATURAL HEALTH PRODUCTS RECALL GUIDE

RE: CONSULTATION ON DRAFT - DRUG AND NATURAL HEALTH PRODUCTS RECALL GUIDE January 14, 2019 Health Products Compliance and Enforcement Unit Regulatory Operations and Regions Branch Health Canada By email to: hc.hpce-cpsal.sc@canada.ca RE: CONSULTATION ON DRAFT - DRUG AND NATURAL

More information

PATIENT REGISTRATION FORM

PATIENT REGISTRATION FORM PATIENT REGISTRATION FORM DATE: PATIENT INFORMATION (PLEASE USE FULL LEGAL NAME, NO NICKNAMES) LAST NAME: FIRST NAME: MI: ADDRESS: CITY: STATE: ZIP: HOME PHONE: CELL PHONE: WORK PHONE: E-MAIL ADDRESS:

More information

SPECIFIED PHYSICAL CONDITIONS MATRIX

SPECIFIED PHYSICAL CONDITIONS MATRIX SPECIFIED PHYSICAL CONDITIONS MATRIX I. Compensation for ACUTE CONDITIONS A1 Proof Lump Sum Enhancer Declaration under penalty of perjury (1) asserting the manifestation of one or more conditions (or the

More information

ENT & Allergy Specialists of VA Registration Form

ENT & Allergy Specialists of VA Registration Form ENT & Allergy Specialists of VA Registration Form Which provider are you seeing today? Dr. James J. Lee Dr. Vickie K. Lee Dr. Rachel Watson Please Print Clearly Last Name PATIENT PERSONAL INFORMATION (please

More information

Pharmacists in Canada A national survey of Canadians on their perceptions and attitudes towards pharmacists in Canada.

Pharmacists in Canada A national survey of Canadians on their perceptions and attitudes towards pharmacists in Canada. in Canada A national survey of Canadians on their perceptions and attitudes towards pharmacists in Canada. February 2015 Prepared for the Canadian Association Methodology Online Survey Sample Size Survey

More information

FLU CLINICS 2012 This year, the surgery will be opening on Saturday 13 TH and 20 th October PLEASE NOTE:

FLU CLINICS 2012 This year, the surgery will be opening on Saturday 13 TH and 20 th October PLEASE NOTE: GOODBYE Vicky one of our Receptionist s, who has now left us, we wish her luck in the future and hope she enjoys her new position in Helsby. FLU CLINICS 2012 This year, the surgery will be opening on Saturday

More information

New Patient Information & Consents

New Patient Information & Consents New Patient Information & Consents Name: DOB: SSN: Gender: Address: City: State: Zip: Home #: Cell #: Other#: Employment Status: Occupation: Email Address: Marital Status: S M D W How did you hear about

More information

IS POLLEN GETTING THE BETTER OF YOU?

IS POLLEN GETTING THE BETTER OF YOU? For seasonal nasal allergy sufferers 6 years and older IS POLLEN GETTING THE BETTER OF YOU? 35% of allergy sufferers who have tried an over-thecounter allergy medication feel there is room for improvement.

More information

HIV and Aging. Making Tobacco Cessation a Priority in HIV/AIDS Services. Objectives. Tobacco Use Among PLWHA

HIV and Aging. Making Tobacco Cessation a Priority in HIV/AIDS Services. Objectives. Tobacco Use Among PLWHA HIV and Aging Making Tobacco Cessation a Priority in HIV/AIDS Services June 27, 2008 Amanda Brown, MPH Ruth Tripp, MPH, RN Objectives To explore existing knowledge of the HIV and smoking connection. To

More information

Acthar TREATMENT JOURNAL

Acthar TREATMENT JOURNAL Acthar TREATMENT JOURNAL Help for patients in the grip of dermatomyositis or polymyositis What is Acthar? Acthar is a prescription medicine used for flares or on a regular basis (maintenance) in people

More information

Patient Name: Date: Address: Primary Care Physician: Online Website On TV In print On the radio

Patient Name: Date:  Address: Primary Care Physician: Online Website On TV In print On the radio 927 W. Myrtle St. Boise, ID 83702 (208) 947-0100 NEW PATIENT INTAKE Patient Name: Date: Email Address: Primary Care Physician: How did you hear about AVT? (Please mark all that apply) Online Website On

More information

Pharmacy 445 Public Health Applications in Pharmacy Jacqueline Gardner, Ph.D. Professor, Department of Pharmacy. Pharmacists Role 1

Pharmacy 445 Public Health Applications in Pharmacy Jacqueline Gardner, Ph.D. Professor, Department of Pharmacy. Pharmacists Role 1 Pharmacy 445 Public Health Applications in Pharmacy Jacqueline Gardner, Ph.D. Professor, Department of Pharmacy Pharmacists Role 1 Promotion of health improvement, wellness, and disease prevention in cooperation

More information

Before starting on Soliris.

Before starting on Soliris. Before starting on Soliris. Important safety information for patients Before you begin Soliris (eculizumab) treatment, your physician will give you a: Medication Guide Soliris Patient Safety Information

More information

Medical Questionnaire

Medical Questionnaire Medical Questionnaire Date: Day Month Year Please answer these questions as completely as you can. We realize that this form is long, but the information in this form will be extremely valuable to us in

More information

WORKPLACE ASSESSMENTS STUDENT INFORMATION SIR30112 Certificate III in Community Pharmacy

WORKPLACE ASSESSMENTS STUDENT INFORMATION SIR30112 Certificate III in Community Pharmacy WORKPLACE ASSESSMENTS STUDENT INFORMATION SIR30112 Certificate III in Community Pharmacy As you are aware you are enrolled in the above qualification through your position with the My Chemist Warehouse

More information

Past Medical History. Chief Complaint: Patient Name: Appointment Date: Page 1

Past Medical History. Chief Complaint: Patient Name: Appointment Date: Page 1 Appointment Date: Page 1 Chief Complaint: (Please write reason, symptoms, condition or diagnosis that prompts your appointment) Past Medical History PERSONAL SKIN HISTORY YES NO Yes - Details Melanoma

More information

PERSONAL HEALTH STATEMENT

PERSONAL HEALTH STATEMENT PERSONAL HEALTH STATEMENT Health declaration (HD) is information submitted by the person regarding their medical state based on a corresponding questionnaire. HD is accessible to the patient s physicians

More information

Smoking Counselling and Cessation Service in Hospital Authority 7 May HA Convention 2014

Smoking Counselling and Cessation Service in Hospital Authority 7 May HA Convention 2014 Smoking Counselling and Cessation Service in Hospital Authority 7 May 2014 - HA Convention 2014 On behalf of COC (Family Medicine) Dr Maria Leung Consultant, Department of Family Medicine New Territories

More information

Patient History Form

Patient History Form Patient History Form Advanced Directive Care Plan? Yes No Name: Birth date: / / Address: Age: Sex: F M STREET DAY YEAR Telephone: Home ( ) CITY STATE DAY YEAR MARITAL STATUS: Divorced Separated Alive/Age

More information

NEW PATIENT VISIT QUESTIONNAIRE

NEW PATIENT VISIT QUESTIONNAIRE HeartHealth A Program of the Dalio Institute of Cardiovascular Imaging NEW PATIENT VISIT QUESTIONNAIRE Name: Date of Birth: / / Address: City: State: Zip: Home Phone #: Work Phone #: Cell #: Email: Preferred

More information

Health Questionnaire

Health Questionnaire Patient Name Date of Birth Thank you for choosing Southern Cancer Center for your care. To help us best prepare for your appointment, please complete this form and bring it to your appointment. If you

More information

Integumentary System

Integumentary System Integumentary System Physiology of Touch Skin: our most sensitive organ Touch: first sense to develop in embryos Most important but most neglected sense How many sensory receptors do we have? (We have

More information

All Other Medications, Dose Times per day Reason for taking the medication. Phone #

All Other Medications, Dose Times per day Reason for taking the medication. Phone # Patient Name: Date of Birth: _ Medical Record Number: Mailing Address: PO Box 29086 Thornton, CO 80229 Phone: 720.215.0700 Fax: 877.332.3131 Allergies Do you have Allergies Yes No If yes, please complete

More information

FOR PATIENTS WITH SYMPTOMS OF SARCOIDOSIS. Treatment Journal. H.P. Acthar Gel is a prescription medication used to treat symptoms of sarcoidosis.

FOR PATIENTS WITH SYMPTOMS OF SARCOIDOSIS. Treatment Journal. H.P. Acthar Gel is a prescription medication used to treat symptoms of sarcoidosis. FOR PATIENTS WITH SYMPTOMS OF SARCOIDOSIS Treatment Journal H.P. Acthar Gel is a prescription medication used to treat symptoms of sarcoidosis. IMPORTANT SAFETY INFORMATION Who should NOT take Acthar?

More information

Providence Medical Group

Providence Medical Group Providence Medical Group To our valued patients: In order to provide you with our full attention when you come for an appointment, we would like to ask you to be aware of the following guidelines. Insurance

More information

Appendix 1 Consultation Document and Survey

Appendix 1 Consultation Document and Survey Appendix 1 Consultation Document and Survey Proposals to stop prescribing medicines for minor conditions NHS Blackburn with Darwen Clinical Commissioning Group continuously reviews the services it commissions

More information

Patient Medical History

Patient Medical History #3 1810, 8 th Street East, Saskatoon SK S7H0T6 Phone (306) 373-5209 Fax (306) 373 5207 Michelle Kormos, Osteopathy (current study) Patient Medical History Please complete the entire medical history and

More information

Medical History Form

Medical History Form General: Medical History Form 1. Chief Complaint: What are the main health concerns you wish to address? 2. Current and Past Treatment: Have you received treatment for these problems? Yes No, if yes, which:

More information

Proposed changes to prescribing in Croydon MALARIA TABLETS. Consultation on proposed changes to NHS prescriptions in Southwark

Proposed changes to prescribing in Croydon MALARIA TABLETS. Consultation on proposed changes to NHS prescriptions in Southwark Proposed changes to prescribing in Croydon MALARIA TABLETS Consultation on proposed changes to NHS prescriptions in Southwark NHS Croydon Clinical Commissioning Group Contents Who are we and what is this

More information

PATIENT HEALTH QUESTIONNAIRE Radiation Oncology

PATIENT HEALTH QUESTIONNAIRE Radiation Oncology REVIEWED DATE / INITIALS Safety: Yes No Are you at risk for falls? Do you have a Pacemaker? Females; Is there a possibility you may be pregnant? Allergies: Yes No If YES, please list medication allergies:

More information

CME/CE POSTTEST CME/CE QUESTIONS

CME/CE POSTTEST CME/CE QUESTIONS CME/CE POSTTEST CME/CE QUESTIONS Controlling Asthma Severity: Identifying Unmet Needs and Optimizing Therapeutic Options There are no fees for participating in and receiving continuing medical education

More information