Adequacy of the Comprehensive Clinical Evaluation Program A Focused Assessment (1997) / Chapter Skim
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Appendix H
Appendix H
Pages 127-130
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From page 127... ...
All individual forms will be complete and legible. Forms forwarded to NMIMC and maintained in the participant record shall be in the following order: Phase I completed: MTF Phase I Diagnosis Form Patient Questionnaire Provider-Administered Symptom Questionnaire Information Release Form Declination/Completion Form 127
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From page 128... ...
Phase II level evaluations are performed only after complete clinically indicated evaluations (including appropriate specialty consultations) are conducted at the MTF and the RMC.
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From page 129... ...
C-Reactive protein Rheumatoid factor ANA Liver function CPK Urinalysis TB skin test (PPD) with controls Chest X-ray Hepatitis serology HIV testing VDRL B12 and folate Thyroid function tests Phase II Consults (if not accomplished at MTF level)
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From page 130... ...
. aspiration Muscle Aches/ Numbness EMG/NCV Chronic Fatigue Polysomnography and MSLT Chronic Cough/SOB Pulmonary consult Pulmonary Unction Tests with exercise and ABG Methacholine challenge If PFTs are normal, consider bronchoscopy with biopsy/ ravage ADEQUACY OF THE CCEP: A FOCUSED ASSESSMENT Abdominal GI consult EGD with biopsy/ aspiration Colonscopy with biopsy Abdominal ultrasound UGI series with small bowel FT Abdominal CT scan Memory Loss (Only if verified by psych evaluation)
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