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Burnsidehospital.asn.au

All other inhalers / puffers and other medications should be taken as usual.
All other inhalers / puffers and other medications should be taken as usual.
Skin Allergy T
Skin Allergy T
essants also contain anti-histamines and should be ceased for 48 hours prior essants also contain anti-histamines and should be ceased for 48 hours prior e the test.
No HISMANAL for 4 weeks befor
e the test.
No HISMANAL for 4 weeks befor
e the test.
elfast for 5 days befor
No Claratyne or T
e the test.
elfast for 5 days befor
No Claratyne or T
etide, Oxis or Symbicort for 12 hours befor etide, Oxis or Symbicort for 12 hours befor ovocation and Hypertonic Saline Challenge
Histamine Pr
ovocation and Hypertonic Saline Challenge
Histamine Pr
etide, Oxis or Symbicort for 12 hours befor etide, Oxis or Symbicort for 12 hours befor olumes, Body Plethysmography
, Static Lung V
fusing Capacity
olumes, Body Plethysmography
, Static Lung V
fusing Capacity
DO NOT SMOKE
DO NOT SMOKE
8202 7272.
nside Respiratory Centr
8202 7272.
nside Respiratory Centr
e unable to manage without your medication or have any questions r e unable to manage without your medication or have any questions r e you to cease some medications for a period of time.
e you to cease some medications for a period of time.
APPOINTMENT
APPOINTMENT
to follow the instructions given for each test
to follow the instructions given for each test
Please read this information carefully as it is important
Please read this information carefully as it is important
est Instructions
Patient Pr
est Instructions
Patient Pr
Email: respiratorycentre@burnsidehospital.asn.au Email: respiratorycentre@burnsidehospital.asn.au BURNSIDE RESPIRATORY CENTRE
BURNSIDE RESPIRATORY CENTRE
Patient and Test Details
Patient and Test Details
PATIENT DETAILS
PATIENT DETAILS
REFERRING DOCTOR
REFERRING DOCTOR
TESTS REQUIRED
TESTS REQUIRED
IMPORTANT: Please see overleaf for pre-test instructions
IMPORTANT: Please see overleaf for pre-test instructions
 Diffusing Capacity (Transfer Factor)  Diffusing Capacity (Transfer Factor) (Clinpath Pathology Form Required) (Clinpath Pathology Form Required) RELEVANT MEDICAL HISTORY (including Communicable Diseases)
RELEVANT MEDICAL HISTORY (including Communicable Diseases)
Doctor’s Signature: . Date:././.
Doctor’s Signature: . Date:././.

Source: http://www.burnsidehospital.asn.au/pdfs/burnside_respiratory_patient_referral.pdf

Onchocerciasis

Onchocerciasis Position Paper SightFirst Long Range Planning (SFLRP) Working Group May 2008 Introduction The mission of the Lions’ SightFirst program is to build comprehensive eye care systems to fight the major causes of blindness and care for the blind or visually impaired. The program funds high quality, sustainable projects that deliver eye care services, develop infrastructure

Microsoft word - ct screening form.doc

First Name:__________________________ M.I. _____ Last Name:____________________________ Male / Female D.O.B:_________________ Employer: _____________________________ MARRIED / SINGLE / OTHER Home Phone: _______________________ Cell: _____________________ Work: ________________________ Address: ____________________________City/State/Zip Code: _____________________________________________ Prim

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