Cholesterol Tracking Flow Sheet

Patient Name: Subjective findings / adverse effects:

Date: Muscle aches Joint pain Weakness, general Memory loss

SSN:

Objective findings (P: PE, L: Lab, X: x-ray):

LABORATORY LFTs ALL WNL Cholesterol, total Triglycerides HDL cholesterol VLDL cholesterol LDL cholesterol Chol/HDL ratio Appraisal today:

Diagnostic plan:

Therapeutic plan:

Disposition:
Return visit scheduled Get lab before Y N Other notes: Physician notified: PH: ____________ FAX: ____________ Phone: [__] FAX: [__] Left message: [__] Phone: [__] FAX: [__] Left message: [__] Phone: FAX: Left message: [__] [__] [__] Phone: [__] FAX: [__] Left message: [__]

C:\Documents and Settings\Administrator\My Documents\MEDICAL-ALL\FORMS-TEMPLATES\FlowSHEETS\flolipids.docx version 2.0 5/21/2012