DVBCWCN3 ;ALB/RLC CRANIAL NERVES WKS TEXT - 1 ; 12 FEB 2007
;;2.7;AMIE;**121**;Apr 10, 1995;Build 9
;
;
TXT ;
;;A. Review of Medical Records:
;;
;;B. Medical History (Subjective Complaints):
;;
;; Comment on:
;;
;; 1. Onset, course since onset.
;; 2. Symptoms.
;; 3. Current treatment, response, side effects.
;; 4. Effects of condition on occupational functioning and daily activities.
;; 5. History of hospitalizations or surgery, location and dates, if known,
;; reason or type of surgery.
;; 6. History of trauma to a cranial nerve, date, type, nerve.
;; 7. History of neoplasm:
;;
;; a. Date of diagnosis, diagnosis.
;; b. Benign or malignant.
;; c. Types of treatment, dates.
;; d. Last date of treatment.
;;
;;C. Physical Examination (Objective Findings):
;;
;; Address each of the following and fully describe current findings:
;;
;; 1. Describe in detail specific motor and sensory impairment, quantifying
;; as much as possible.
;; 2. If smell or taste is affected, please also complete the appropriate
;; worksheet.
;;
;;D. Diagnostic and Clinical Tests:
;;
;; 1. Include results of all diagnostic and clinical tests conducted
;; in the examination report.
;;
;;E. Diagnosis:
;;
;; 1. Identify the nerve and the side.
;; 2. Identify the disorder (i.e., paralysis, neuritis, neuralgia).
;; 3. State etiology.
;;
;;
;;Signature: Date:
;;END
--- Routine Detail --- with STRUCTURED ROUTINE LISTING ---[H[J[2J[HDVBCWCN3 1595 printed Sep 23, 2025@19:26:10 Page 2
DVBCWCN3 ;ALB/RLC CRANIAL NERVES WKS TEXT - 1 ; 12 FEB 2007
+1 ;;2.7;AMIE;**121**;Apr 10, 1995;Build 9
+2 ;
+3 ;
TXT ;
+1 ;;A. Review of Medical Records:
+2 ;;
+3 ;;B. Medical History (Subjective Complaints):
+4 ;;
+5 ;; Comment on:
+6 ;;
+7 ;; 1. Onset, course since onset.
+8 ;; 2. Symptoms.
+9 ;; 3. Current treatment, response, side effects.
+10 ;; 4. Effects of condition on occupational functioning and daily activities.
+11 ;; 5. History of hospitalizations or surgery, location and dates, if known,
+12 ;; reason or type of surgery.
+13 ;; 6. History of trauma to a cranial nerve, date, type, nerve.
+14 ;; 7. History of neoplasm:
+15 ;;
+16 ;; a. Date of diagnosis, diagnosis.
+17 ;; b. Benign or malignant.
+18 ;; c. Types of treatment, dates.
+19 ;; d. Last date of treatment.
+20 ;;
+21 ;;C. Physical Examination (Objective Findings):
+22 ;;
+23 ;; Address each of the following and fully describe current findings:
+24 ;;
+25 ;; 1. Describe in detail specific motor and sensory impairment, quantifying
+26 ;; as much as possible.
+27 ;; 2. If smell or taste is affected, please also complete the appropriate
+28 ;; worksheet.
+29 ;;
+30 ;;D. Diagnostic and Clinical Tests:
+31 ;;
+32 ;; 1. Include results of all diagnostic and clinical tests conducted
+33 ;; in the examination report.
+34 ;;
+35 ;;E. Diagnosis:
+36 ;;
+37 ;; 1. Identify the nerve and the side.
+38 ;; 2. Identify the disorder (i.e., paralysis, neuritis, neuralgia).
+39 ;; 3. State etiology.
+40 ;;
+41 ;;
+42 ;;Signature: Date:
+43 ;;END
