Modified COVID-19 Yorkshire Rehabilitation Screening (C19-YRS)
| Gender: <.Patient_Gender.>
|
<*Answer_7771*>
|
|
<*Answer_7772*>
|
|Information contained in this note is based on a self-report assessment
|and is not sufficient to use alone for diagnostic purposes. Assessment
|results should be verified for accuracy and used in conjunction with
|
|other diagnostic activities.
| Date Given: <.Date_Given.>
| Clinician: <.Staff_Ordered_By.>
| Location: <.Location.>
|
| Veteran: <.Patient_Name_Last_First.>
| SSN: <.Patient_SSN.>
| DOB: <.Patient_Date_Of_Birth.> (<.Patient_Age.>)
|
