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130 Cards in this Set

  • Front
  • Back
Annual Screening
HIV Dxpoesed in utero to des
D/C of PAP's
Hysterectomy with cervix removal
No Hx of Abnml pap
History of CIN 2-3
Screened annually until 3 neg paps
Self Breast Exams
Begin at age 20
Performed at min 3 years
Annually at age 40
Mamos
annually ate age 40
1st degree relative at 10 years prior to onset of family then annually
Lipids Screen
After age 45
Ages 20-45 if clinically indicated
Colorectal Cancer Screen
Begins at age 50
Exceptions to Exam recommendations
Discussed and understanding on SF 600
PHA instruction
OPNAVINST 6120.3
When and how often do members recieve PHA
Annually and in 30 days of birthday
What is a PHA documented on?
DD2766/ NAVMED 6120/4 or spec sf600
Assessment includes
BP, HT, WT, Colorectal cancer screen, Lipids, Imms, Cardio risk, readiness, occupational risk, female specific, and male specific tests
Counseling reqirements
Health promos, family planning, Medication and supplement use
If member is found not medically fit to separate what form is it documented on?
MANMED CH 15 Art. 15-20/21
Request for previous med records form
DD877
Orange
zero 6150/30
Green
one 6150/21
Yellow
two 6150/22
Gray
Three 6150/23
Tan
four 6150/24
Blue
five 6150/25
White
six 6150/26
Almond
seven 6150/27
Pink
Eight 6150/28
Red
Nine 6150/29
Child prefix
01-19
Active Duty prefix
20
Spouse prefix
30-39
Mother prefix
40-44
Father Prefix
45-49
Mother in Law prefix
50-54
Father in law prefix
55-59
Other auth prefix
60-69
Civilian emergency prefix
98
All others (foreign)
99
Red tape category
Active Duty OUTpatient
Green Tape Category
Active duty INpatient
Black tape category
all others
Blue tape category
Dental
What is used to mark the boxes on the med record
black "X"
Record closed entries on...
6150/4
Med record belongs to...
US Gov't
who had custodial responsibility on ship
SMDR
IF member is UA what happens to his/her record
Forwarded to PSD after 10 days
Upon transfer what form needs to be completed
6150/7 *pink card*
If record is lost..
Cognizant cust. will make replacement record marked with "REPLACEMENT" and SF600
When record is illegible
mark with "DUPLICATE RECORD"
What is the publication for filing
MANMED CH 16, Article 16-18
DD2766
Preventative and flow chart
NAVMED 6230/4
Adult IMMS record
NAVMED 6000/2
HIV testing
DD 771
Eye wear protection
NAVMED 6470/10
Occupational exposure to Ion Rad
NAVMED 6470/11
Record of Exposure to Ionizing rad
DD form 2215
Ref Audio
DD form 2216
Hearing con program
NAVMED 6224/1
TB contact/reactor
NAVMED 6260/5
Asbestos med survalience
DD form 2493-1
Asbestos exposure part one
DD form 2493-2
Asbestos exposure part two
OPNAV 5100/15
Med surveillance ?
OPNAV 5510/414
Personnel Reliability Program
SF 558
Emergency care and Treatment
SF600
Chronological Record of Medical Care
SF 513
Consult Report
DD Form 2161
referral for civ. med. care
DD 2064
Certificate of Death
SF 503
Autopsy Protocol
SF 533
Auth for Autopsy
SF 523A
Dipos of Bod
SF523B
Auth for tissue donation
NAVMED 6300/5
IN PT Admit/Dispo
SF 502
Narrative Summary
AF 509
Progress notes
SF 516
Operation report
SF 517
Anesthesia
SF 522
Admin of Anesthesia
SF 533,
Prenatal-Pregnancy
DD form 602
PT education tags
DD form 2005
Privacy act
NAVMED 1300/1
Suitability screen for family
NAVPERS 1300/16
Suitability for overseas
NAVMED 6100/1
med board cover sheet
NAVMED 6100/2
Med Boards Statement of Pt
NAVMED 6100/3
Med Board Cert relative to Hearing
NAVMED 6100/5
Abbreviated temp limited duty
SF 2842-C
Physicians Statement for Employee Disability
SF47
Motor vehicle cert
SF 78
Cert of med exam
DD Form 2808
Med Exam
DD form 28107-1
Report of med hx
NAVMED6120/1
Competence of Duty Exam
NAVMED6120/2
Officer Physicals
NAVMED6120/3
Annual exam
NAVMED 6150/2
Special Physicals
NAVMED6150/4
Abstract of med hx
NAVJAG 5800/10
Injury Report
NAVJAG Report
Investigation surrounding injury to service member
DD Form 2792
EFMP
DD Form 2569
Third party collection program
DD Form 877
Request for records
OPNAV 5211/9
Record of Disclosure
SF 217
Med Report Epilepsy
SF 515
TIssue Exam
SF 519A
Rad Report
SF 519B
Med Record-Rad consult report
SF 518
Blood or blood product transfusion
SF 520
Electrocadiogram request
SF 524
Rad Therapy
SF 525
Rad therapy summary
SF 526
Interstial therpay
SF 528
Muscle func by nerve distro face neck and upper extremity
SF 529
Muscle function by nerve distro trunk and lower extremity
AF 530
Newrologyical Exam
SF 531
Anatomical Figure
SF 541
Gyno Cyto report
SF 545
Lab report display
SF 580
ECG Report
SF 511
Vital Signs
SF 512
Plotting Chart
SF 512A
Plotting chart blood pressure
Dental Record Hypersensitivty
Enter in RED across top of EZ603/603A
Dental Class 1
White, no dental tx req'd
Dental Class 2
Green, minor dental tx req'd
Dental Class 3
Yellow, Has pathological prob's
Dental Class 4
Red, Dental class is unknown
BUMEDINST6320.72 Series
Non-Naval Health care program
NAVMEDCOMINST 6320.3 Series
Med and dent care for eligible for persons at navy med department fac
Individuals designated as a Certifying official for the NON-Federal Medical Health Care Claim form:
Medical department Rep
Health benefits adviser
Senor officer
Eligibility Requirements
Spouses
Children (up to age 21 or 23 if enrolled in college) or identified as mentally or physically incapable
Con't requirements
Deceased Active Duty or Retired Members
Un-remarried spouses
Children