ࡱ> Y[X & bjbj 44ee62228j2     =??????$hXcc  x~  == ',}wF)0lcc :  Patient Name: _____________________________________ Adult Medication Sheet Date of Birth: _____________________________________ Medical Record Number: ____________________________  DateMedication Dose/Route Frequency daily bid tid qid nightly prn daily bid tid qid nightly prn daily bid tid qid nightly prn daily bid tid qid nightly prn daily bid tid qid nightly prn daily bid tid qid nightly prn daily bid tid qid nightly prn daily bid tid qid nightly prn daily bid tid qid nightly prn daily bid tid qid nightly prn daily bid tid qid nightly prn daily bid tid qid nightly prn daily bid tid qid nightly prn DateShort Term MedicationDateShort Term MedicationDateShort Term Medication     http://www.acponline.org/practiceforms :;<RV ( - 8 9 : \ h i j вЧЍЧ~ЧoЧ`Чj,hB hV0CJUaJjhB hV0CJUaJj hB hV0CJUaJj hB hV0CJUaJhB hi CJaJhB h[CJaJjhB hV0CJUaJjhB hV0CJUaJhi jhV0hV0CJUaJ h5hi h5CJaJhbrchhIs!;<  FfE $Ifgd $Ifgdi gdgd        - . / 0 1 2 3 4 5 6 7 8 : ] ^ _ $IfgdHFfK $Ifgd[ $Ifgdi Ff $Ifgd_ ` a b c d e f g h j FfW $IfgdHFf $Ifgd    Ffc $IfgdHFf $Ifgd  ( ) * L X Y Z |    < H I J l x y xthd] hh?lh?lhB h?l5CJaJhj\1hB hV0CJUaJj-hB hV0CJUaJjP*hB hV0CJUaJj&hB hV0CJUaJjD#hB hV0CJUaJjhB hV0CJUaJj8hB hV0CJUaJhB h[CJaJhi jhB hV0CJUaJ$ ! " # $ % & ' ( * M N O P Q R S T U V W X Z } ~  Ffo $IfgdHFf $Ifgd Ff{$ $IfgdHFf $Ifgd             = > ? Ff+ $IfgdHFf( $Ifgd? @ A B C D E F G H J m n o p q r s t u v w x y ~ $$Ifa$gdB `gdFf2 $IfgdHFf / $Ifgd~ $IfgdFf*6 $$Ifa$gdB 8//// $IfgdkdD8$$Iflֈ.f!+  82 t0,644 laytB  /kd8$$Iflֈ.f!+  82 t0,644 laytB $Ifgd /kd9$$Iflֈ.f!+  82 t0,644 laytB $Ifgd $Ifgd 8//// $Ifgdkdu:$$Iflֈ.f!+  82 t0,644 laytB  /&`gdkd0;$$Iflֈ.f!+  82 t0,644 laytB $Ifgd # % & hh?lhw{Mh[~ijh[~iU " # $ % & `gd$a$gdw{Mgdw{M 21h:pw{M/ =!"@#$% Dd P  # C"*88$$If!v h#v #vZ#v [:V lg t08,6,5 5Z5 [/ ytB Mkd$$Iflg D R`!%q(+ ZZZZZZ[[[[ t08,6,,,,44 laytB DdJ  3 #" (($$If!v h#v #vZ#v [:V l t08,6,5 5Z5 [ytB Mkd*$$Ifl D R`!%q(+ ZZZZZZ[[[[ t08,6,,,,44 laytB DdP  3 3"(($$If!v h#v #vZ#v [:V l t08,6,5 5Z5 [ytB Mkd$$Ifl D R`!%q(+ ZZZZZZ[[[[ t08,6,,,,44 laytB DdP  3 3"(($$If!v h#v #vZ#v [:V l t08,6,5 5Z5 [ytB Mkd6 $$Ifl D R`!%q(+ ZZZZZZ[[[[ t08,6,,,,44 laytB DdP  3 3"(($$If!v h#v #vZ#v [:V l t08,6,5 5Z5 [ytB Mkd$$Ifl D R`!%q(+ ZZZZZZ[[[[ t08,6,,,,44 laytB DdP  3 3"(($$If!v h#v #vZ#v [:V l t08,6,5 5Z5 [ytB MkdB$$Ifl D R`!%q(+ ZZZZZZ[[[[ t08,6,,,,44 laytB DdP  3 3"(($$If!v h#v #vZ#v [:V l t08,6,5 5Z5 [ytB Mkd$$Ifl D R`!%q(+ ZZZZZZ[[[[ t08,6,,,,44 laytB DdP  3 3"(($$If!v h#v #vZ#v [:V l t08,6,5 5Z5 [ytB MkdN$$Ifl D R`!%q(+ ZZZZZZ[[[[ t08,6,,,,44 laytB DdP   3 3"(($$If!v h#v #vZ#v [:V l t08,6,5 5Z5 [ytB Mkd$$Ifl D R`!%q(+ ZZZZZZ[[[[ t08,6,,,,44 laytB DdP   3 3"(( $$If!v h#v #vZ#v [:V l t08,6,5 5Z5 [ytB MkdZ $$Ifl D R`!%q(+ ZZZZZZ[[[[ t08,6,,,,44 laytB DdP   3 3"(( $$If!v h#v #vZ#v [:V l t08,6,5 5Z5 [ytB Mkd#$$Ifl D R`!%q(+ ZZZZZZ[[[[ t08,6,,,,44 laytB DdP   3 3"(( $$If!v h#v #vZ#v [:V l t08,6,5 5Z5 [ytB Mkdf'$$Ifl D R`!%q(+ ZZZZZZ[[[[ t08,6,,,,44 laytB DdP   3 3"(( $$If!v h#v #vZ#v [:V l t08,6,5 5Z5 [ytB Mkd*$$Ifl D R`!%q(+ ZZZZZZ[[[[ t08,6,,,,44 laytB DdP  3 3"(( $$If!v h#v #vZ#v [:V l t08,6,5 5Z5 [ytB Mkdr.$$Ifl D R`!%q(+ ZZZZZZ[[[[ t08,6,,,,44 laytB DdP  3 3"(($$If!v h#v #vZ#v [:V l t08,6,5 5Z5 [ytB Mkd1$$Ifl D R`!%q(+ ZZZZZZ[[[[ t08,6,,,,44 laytB F$$If!vh#v#v #v#v #v8#v2 :V l  t<0,655 55 5852 p<ytB kd4$$Iflֈ.f!+  82  t<0,644 lap<ytB $$If!vh#v#v #v#v #v8#v2 :V l t0,655 55 5852 ytB $$If!vh#v#v #v#v #v8#v2 :V l t0,655 55 5852 ytB $$If!vh#v#v #v#v #v8#v2 :V l t0,655 55 5852 ytB $$If!vh#v#v #v#v #v8#v2 :V l t0,655 55 5852 ytB $$If!vh#v#v #v#v #v8#v2 :V l t0,655 55 5852 ytB ^ 666666666vvvvvvvvv666666>6666666666666666666666666666666666666666666666666hH6666666666666666666666666666666666666666666666666666666666666666662 0@P`p2( 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p8XV~_HmH nH sH tH @`@ NormalCJ_HaJmH sH tH DA`D Default Paragraph FontRi@R 0 Table Normal4 l4a (k ( 0No List jj  Table Grid7:V04@4 w{M0Header  H$6/6 w{M0 Header CharCJaJ4 @"4 w{M0Footer  H$6/16 w{M0 Footer CharCJaJPK![Content_Types].xmlN0EH-J@%ǎǢ|ș$زULTB l,3;rØJB+$G]7O٭V$ !)O^rC$y@/yH*񄴽)޵߻UDb`}"qۋJחX^)I`nEp)liV[]1M<OP6r=zgbIguSebORD۫qu gZo~ٺlAplxpT0+[}`jzAV2Fi@qv֬5\|ʜ̭NleXdsjcs7f W+Ն7`g ȘJj|h(KD- dXiJ؇(x$( :;˹! I_TS 1?E??ZBΪmU/?~xY'y5g&΋/ɋ>GMGeD3Vq%'#q$8K)fw9:ĵ x}rxwr:\TZaG*y8IjbRc|XŻǿI u3KGnD1NIBs RuK>V.EL+M2#'fi ~V vl{u8zH *:(W☕ ~JTe\O*tHGHY}KNP*ݾ˦TѼ9/#A7qZ$*c?qUnwN%Oi4 =3N)cbJ uV4(Tn 7_?m-ٛ{UBwznʜ"Z xJZp; {/<P;,)''KQk5qpN8KGbe Sd̛\17 pa>SR! 3K4'+rzQ TTIIvt]Kc⫲K#v5+|D~O@%\w_nN[L9KqgVhn R!y+Un;*&/HrT >>\ t=.Tġ S; Z~!P9giCڧ!# B,;X=ۻ,I2UWV9$lk=Aj;{AP79|s*Y;̠[MCۿhf]o{oY=1kyVV5E8Vk+֜\80X4D)!!?*|fv u"xA@T_q64)kڬuV7 t '%;i9s9x,ڎ-45xd8?ǘd/Y|t &LILJ`& -Gt/PK! ѐ'theme/theme/_rels/themeManager.xml.relsM 0wooӺ&݈Э5 6?$Q ,.aic21h:qm@RN;d`o7gK(M&$R(.1r'JЊT8V"AȻHu}|$b{P8g/]QAsم(#L[PK-![Content_Types].xmlPK-!֧6 0_rels/.relsPK-!kytheme/theme/themeManager.xmlPK-!0C)theme/theme/theme1.xmlPK-! ѐ' theme/theme/_rels/themeManager.xml.relsPK] &%4 5558 &   _   ? ~ &  L# @0(  B S  ?FIKNvy{~  69;>fikn&)+.VY[^$'$'i z.V05:}Ew{M ]brc[~i?lIssT~8'B [rH@@ @{&(@UnknownG*Ax Times New Roman5Symbol3. *Cx ArialA$BCambria Math"qhF4gYY!xr03HP ?2!xx  Akila Berry Windows UserOh+'0x  4 @ LX`hp Akila Berry Normal.dotmWindows User3Microsoft Office Word@F#@Tݛ@l,}Y՜.+,0 hp   American College of Physicians  Title  !"#$%&'()*+,-./012345678:;<=>?@ABCDEFGIJKLMNOQRSTUVWZRoot Entry F,}\Data ;1Table9WordDocument44SummaryInformation(HDocumentSummaryInformation8PCompObjr  F Microsoft Word 97-2003 Document MSWordDocWord.Document.89q