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CONDITIONS:
CURRENT MEDS:
INSTRUCTIONS:
Copy to Patient
Fasting Instructions
THERAPEUTIC MONITORING
ANEMIA:
Anemia Initial
Anemia Refractory
CHF:
Baseline
Follow-up
Standing Order Q3M
CKD Stage 3:
Annual
eGFR/ACR Q6M
DM:
Annual
A1C Q3M
DYSLIPIDEMIA:
Screening
HEPATITIS:
LFTs
LFT Elevation Acute
Chronic Elevated LFTs
Chronic HBV FU
HYPERTENSION:
Annual
INFERTILITY:
Infertility Female
Male
Abn Semen Analysis
PRENATAL:
Prenatal:First visit labs
Prenatal:Discretionary labs
Prenatal:Gestational HTN
OTHERS:
Autoimmune ANA, RF
CBC
Celiac disease ~$125
Bariatric
annual
Dementia
Eating disorder workup
Fatigue
Gyne Cancer
INR - Standing Order
Osteoporosis Female
Male
PCOS workup
Recurrent Pregnancy Loss
Renal Function
Stool O+P,C+S
Restless Leg
Thrombosis screen
Thyroid screen
TSH Standing Order
Urine C&S
Vaginitis
Approximate cost of todays lab work:
$
Choose Tickler reminder date
4 weeks
6 weeks
