NATL CAREGIVER ASSESS FY21-Q3 (862)    ENCOUNTER FORM (357)

Name Value
NAME NATL CAREGIVER ASSESS FY21-Q3
SIMPLEX/DUPLEX DUPLEX,LONG-EDGE BINDING
BRIEF DESCRIPTION National Care Giver Support April 2021
TYPE OF USE OUTPATIENT ENCOUNTER FORM
COMPILED? NO
USE ICR? YES
TOOLKIT YES
RIGHT MARGIN 133
PAGE LENGTH 80
NUMBER OF PAGES 2
SCANNED/MANUAL DATA ENTRY YES
PAPER SIZE LETTER (8 1/2 x 11)
ORIENTATION PORTRAIT
TEXT SIZE 133 COLUMNS x 80 LINES
VERSION 2.1
PAGE INFORMATION
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