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{\footer\pard\itap0\nowidctlpar\plain\f0\fs16\b\par\pard\itap0\nowidctlpar\qc\brdrt\brdrs\brdrw10\brsp20\brdrbtw\brdrs\brdrw10\brsp20 GP partners Adelaide February 2009\par\pard\itap0\nowidctlpar\qc\plain\f0\fs16 Acknowledging with thanks the original work done by the Southern Division of General Practice 2007\par\plain\f0\fs16\b 45-49 Year Old Health Check - Page \plain\f0\fs16\b{\txfielddef{\*\txfieldstart\txfieldtype3\txfieldflags0}{\*\txfielddatadef\txfielddatatype3\txfielddata 00030001}{\*\txfieldtext 1}{\field{\*\fldinst{ PAGE \\* Arabic }}{\fldrslt{1}}}}\par}\pard\itap0\nowidctlpar\qc\plain\f0\fs36\b 45 - 49 Year Old Health Check\plain\f1\fs24\par\pard\s16\itap0\nowidctlpar\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080\plain\f0\fs24\b\i\ul\par Date:\plain\f0\fs24  \plain\f0\fs24{\txfielddef{\*\txfieldstart\txfieldtype1\txfieldflags26}{\*\txfielddatadef\txfielddatatype1\txfieldbin\txfielddata 39000000}{\*\txfieldtext <<Miscellaneous:Date>>}{\field{\*\fldinst { HYPERLINK "9" }}{\fldrslt{<<Miscellaneous:Date>>}}}}\plain\f0\fs20\b\tab\tab\tab\plain\f0\fs28\b{\*\txfieldstart\txfieldtype0\txfieldflags26}<<Practice:Name>>{\*\txfieldend}\plain\f0\fs28\b\par\plain\f0\fs20\b\ul\par\trowd\irow0\irowband0\trgaph100\trleft0\trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl100\trpaddr108\trpaddfl3\trpaddft3\trpaddfr3\trpaddfb3\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth4819\cellx4819\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth4927\cellx9746\pard\s16\intbl\nowidctlpar\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080\plain\f0\fs20{\*\txfieldstart\txfieldtype0\txfieldflags26}<<Patient Demographics:Full Name>>{\*\txfieldend}\plain\f0\fs20\b\ul\cell\plain\f0\fs20{\*\txfieldstart\txfieldtype0\txfieldflags26}<<Patient Demographics:DOB>>{\*\txfieldend}\plain\f0\fs20\b\ul\cell\row\trowd\irow1\irowband1\trgaph100\trleft0\trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl100\trpaddr108\trpaddfl3\trpaddft3\trpaddfr3\trpaddfb3\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth4819\cellx4819\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth4927\cellx9746\pard\s16\intbl\nowidctlpar\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080\plain\f0\fs20{\*\txfieldstart\txfieldtype0\txfieldflags26}<<Patient Demographics:Full Address>>{\*\txfieldend}\plain\f0\fs20\par Phone (Home): \plain\f0\fs20{\*\txfieldstart\txfieldtype0\txfieldflags26}<<Patient Demographics:Phone (Home)>>{\*\txfieldend}\plain\f0\fs20\par Mobile: \plain\f0\fs20{\*\txfieldstart\txfieldtype0\txfieldflags26}<<Patient Demographics:Phone (Mobile)>>{\*\txfieldend}\plain\f0\fs20\b\ul\cell\plain\f0\fs20{\*\txfieldstart\txfieldtype0\txfieldflags26}<<Doctor:Name>>{\*\txfieldend}\plain\f0\fs20\cell\row\trowd\irow2\irowband2\lastrow\trgaph100\trleft0\trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl100\trpaddr108\trpaddfl3\trpaddft3\trpaddfr3\trpaddfb3\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth4819\cellx4819\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth4927\cellx9746\pard\s16\intbl\nowidctlpar\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080 I \plain\f0\fs20{\*\txfieldstart\txfieldtype0\txfieldflags26}<<Patient Demographics:Full Name>>{\*\txfieldend}\plain\f0\fs20  understand what this health check involves and give consent for this health check to be undertaken.\cell Patient\loch\f0\hich\f0\'92s signature:\par\pard\s16\intbl\nowidctlpar\sb113\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080 Date:\cell\row\pard\s16\itap0\nowidctlpar\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080\plain\f0\fs20\b\par\plain\f0\fs32\b\i\ul Patient History\par\plain\f0\fs20\b\ul\par Medical History\par\plain\f0\fs20{\*\txfieldstart\txfieldtype0\txfieldflags26}<<Clinical Details:History List>>{\*\txfieldend}\plain\f0\fs20\b\ul\par\par Medication:\par\pard\s16\itap0\nowidctlpar\sl360\slmult1\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080\plain\f0\fs20{\txfielddef{\*\txfieldstart\txfieldtype1\txfieldflags26}{\*\txfielddatadef\txfielddatatype1\txfielddata 50004c0053004d00470042000000}{\*\txfieldtext <<Clinical Details:Medication List>>}{\field{\*\fldinst { HYPERLINK "PLSMGB" }}{\fldrslt{<<Clinical Details:Medication List>>}}}}\plain\f0\fs20\par\plain\f0\fs20\b\ul Allergies:\par\plain\f0\fs20{\*\txfieldstart\txfieldtype0\txfieldflags26}<<Clinical Details:Allergies>>{\*\txfieldend}\plain\f0\fs20\b\ul\par Immunisation:\par\pard\s16\itap0\nowidctlpar\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080\plain\f0\fs20{\*\txfieldstart\txfieldtype0\txfieldflags26}<<Clinical Details:Immunisation List>>{\*\txfieldend}\plain\f0\fs20\par\par\plain\f0\fs20\b\ul Social History:\plain\f0\fs20\b\par\plain\f0\fs20{\*\txfieldstart\txfieldtype0\txfieldflags26}<<Clinical Details:Social History>>{\*\txfieldend}\plain\f0\fs32\b\par\par\trowd\irow0\irowband0\lastrow\trgaph108\trleft0\trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfr3\trpaddfb3\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth9746\cellx9746\pard\s16\intbl\nowidctlpar\qc\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080\plain\f0\fs24\b RISK FACTOR ASSESSMENT\cell\row\trowd\irow0\irowband0\trgaph100\trleft0\trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl100\trpaddr108\trpaddfl3\trpaddft3\trpaddfr3\trpaddfb3\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth1276\cellx1276\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth2864\cellx4140\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth1956\cellx6096\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth3650\cellx9746\pard\s16\intbl\nowidctlpar\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080 Risk Factor\cell Information/ Questions\cell Assessment\cell Intervention/ advice/ information recommended:\cell\row\trowd\irow1\irowband1\trgaph100\trleft0\trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl100\trpaddr108\trpaddfl3\trpaddft3\trpaddfr3\trpaddfb3\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth1276\cellx1276\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth2864\cellx4140\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth1956\cellx6096\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth3650\cellx9746\pard\s16\intbl\nowidctlpar\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080\plain\f0\fs20 Family History\par\par\cell Tick relevant box\par add details\par\pard\intbl\nowidctlpar\plain\f2\fs26 r\plain\f1\fs24   \plain\f0\fs20 Alcohol problems\plain\f3\fs17\par\pard\s16\intbl\nowidctlpar\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Bowel cancer\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Breast cancer\par\pard\intbl\nowidctlpar\plain\f2\fs26 r\plain\f1\fs24   \plain\f0\fs20 Diabetes\plain\f3\fs17\par\pard\s16\intbl\nowidctlpar\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Heart disease \par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Other disease\par\par\plain\f0\fs20{\*\txfieldstart\txfieldtype0\txfieldflags26}<<Clinical Details:Family History>>{\*\txfieldend}\plain\f0\fs20\cell\par\par\par\par Intervention recommended?\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Yes\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  No\cell\cell\row\trowd\irow2\irowband2\trgaph100\trleft0\trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl100\trpaddr108\trpaddfl3\trpaddft3\trpaddfr3\trpaddfb3\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth1276\cellx1276\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth2864\cellx4140\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth1956\cellx6096\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth3650\cellx9746\pard\s16\intbl\nowidctlpar\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080 Smoking\par\par cigarettes, pipes, cigars\cell\plain\f0\fs20{\*\txfieldstart\txfieldtype0\txfieldflags26}<<Clinical Details:Smoking>>{\*\txfieldend}\plain\f0\fs20\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Yes, details\par no./day___\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  No\cell\par Intervention recommended?\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Yes\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  No, non smoker\cell If yes, examples of intervention\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Assess readiness to quit\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Offer advice to quit\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20\i  Lifescripts\plain\f0\fs20  Smoking Assessment, General Guidelines and smoke-free prescription\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  \plain\f0\fs20\i QUIT\plain\f0\fs20  booklet\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  appointment to discuss smoking \par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Other:\cell\row\trowd\irow3\irowband3\trgaph100\trleft0\trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl100\trpaddr108\trpaddfl3\trpaddft3\trpaddfr3\trpaddfb3\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth1276\cellx1276\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth2864\cellx4140\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth1956\cellx6096\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth3650\cellx9746\pard\s16\intbl\nowidctlpar\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080 Alcohol\cell\plain\f0\fs20{\*\txfieldstart\txfieldtype0\txfieldflags26}<<Clinical Details:Alcohol>>{\*\txfieldend}\plain\f0\fs20\b\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Never \par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Yes, details\par How often?\par __g/day\par How often more than 5 drinks on one occasion?__\par In the last 12 months have you had any concerns about your drinking?\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Yes\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  No \plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Unsure\cell Alcohol Use:\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Within guidelines\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Risky \par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  High risk\par\par\par Intervention recommended?\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Yes\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  No \cell\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Provide information about low-risk alcohol use\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Assess readiness to address alcohol use\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20\i  Lifescripts\plain\f0\fs20  -Alcohol use Assessment, General guidelines and low-risk alcohol use prescription\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  appointment to discuss alcohol use\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Other:\cell\row\trowd\irow4\irowband4\lastrow\trgaph100\trleft0\trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl100\trpaddr108\trpaddfl3\trpaddft3\trpaddfr3\trpaddfb3\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth1276\cellx1276\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth2864\cellx4140\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth1956\cellx6096\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth3650\cellx9746\pard\s16\intbl\nowidctlpar\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080 Nutrition\cell ___Portions of fruit/ day\par ___Portions of Vegetables/ day\par Number of meals a day?__\par Do you choose low fat products? Y/N\par What kind of fats do you eat? \par Do you have any concerns about your diet?\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Yes\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  No\cell\par\par\par\par  \par\par\par Intervention recommended?\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Yes\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  No\cell Examples of intervention\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Advise to follow \plain\f0\fs20\i NHMRC guidelines for Australian adults\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Assess interest in improving nutrition \par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  \plain\f0\fs20\i Lifescripts\plain\f0\fs20  Nutrition Assessment, General Guidelines and healthy eating prescription\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  appointment to discuss nutrition\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Other:\cell\row\trowd\irow0\irowband0\trgaph100\trleft0\trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl100\trpaddr108\trpaddfl3\trpaddft3\trpaddfr3\trpaddfb3\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth1276\cellx1276\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth2864\cellx4140\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth1956\cellx6096\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth3650\cellx9746\pard\s16\intbl\nowidctlpar\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080\plain\f0\fs20 Physical Activity\cell How many times a week do you do > 20 minutes of vigorous activity? ____\par How many times a week do you do > 30 minutes of walking for exercise? ____\par How many times a week do you do > 20 minutes of moderate activity? ____\cell Intervention recommended?\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Yes\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20 No\cell Examples of intervention\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Assess interest in increasing activity levels\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20\i  Lifescripts\plain\f0\fs20  physical activity Assessment, General Guidelines and\par active lifestyle prescription\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Appointment to discuss physical activity\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Other:\cell\row\trowd\irow1\irowband1\lastrow\trgaph100\trleft0\trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl100\trpaddr108\trpaddfl3\trpaddft3\trpaddfr3\trpaddfb3\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth1276\cellx1276\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth2864\cellx4140\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth1956\cellx6096\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth3650\cellx9746\pard\s16\intbl\nowidctlpar\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080 Weight \cell Have you lost/ gained weight more than 5kg in the last 6 months? Y/N details\par Have you gained more than 10kg since you were 20 years old? Y/N details\cell Height         m\par Weight         kg\par BMI\par Waist circumference:\par      cm\par\par Is BMI above 25? Y/N\par\cell Examples of intervention\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Assess interest in weight management for the long term\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  \plain\f0\fs20\i Lifescripts\plain\f0\fs20  weight management Assessment, General Guidelines and\par healthy weight prescription \par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Appointment to discuss weight management\par\plain\f2\fs26 r\plain\f0\fs24   \plain\f0\fs20 Other:\cell\row\pard\s16\itap0\nowidctlpar\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080\par\trowd\irow0\irowband0\lastrow\trgaph108\trleft0\trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfr3\trpaddfb3\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth9746\cellx9746\pard\s16\intbl\nowidctlpar\qc\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080\plain\f0\fs24\b SCREENING FOR HEALTH PROBLEMS\plain\f0\fs22\b\cell\row\trowd\irow0\irowband0\trgaph100\trleft0\trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl100\trpaddr108\trpaddfl3\trpaddft3\trpaddfr3\trpaddfb3\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth1446\cellx1446\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth2694\cellx4140\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth1962\cellx6102\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth3644\cellx9746\pard\s16\intbl\nowidctlpar\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080\plain\f0\fs24\b Risk Factor\cell Information/ Questions\cell Assessment\cell Intervention/ advice/ information recommended:\cell\row\trowd\irow1\irowband1\trgaph100\trleft0\trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl100\trpaddr108\trpaddfl3\trpaddft3\trpaddfr3\trpaddfb3\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth1446\cellx1446\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth2694\cellx4140\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth1962\cellx6102\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth3644\cellx9746\pard\s16\intbl\nowidctlpar\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080\plain\f0\fs20 Depression\par\par\cell\loch\f0\hich\f0\'93Over the last 2 weeks, have you felt down, depressed or hopeless?\'94\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  No \par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Yes, details\par\par\loch\f0\hich\f0\'93Over the last 2 weeks, have you felt little interest or pleasure in doing things?\'94\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  No \par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Yes, details\cell Intervention recommended?\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Yes\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  No\cell Examples of intervention\par\plain\f2\fs26 r\plain\f0\fs24   \plain\f0\fs20 Suicide risk assessment\par\plain\f2\fs26 r\plain\f0\fs24   \plain\f0\fs20 Counselling\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  CBT\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Pharmacotherapy\par\plain\f2\fs26 r\plain\f0\fs24   \plain\f0\fs20 Referral to psychologist\par\plain\f2\fs26 r\plain\f0\fs24   \plain\f0\fs20 Referral to psychiatrist\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Appointment to discuss mental wellbeing\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Mental Health Plan\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Other:\cell\row\trowd\irow2\irowband2\lastrow\trgaph100\trleft0\trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl100\trpaddr108\trpaddfl3\trpaddft3\trpaddfr3\trpaddfb3\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth1446\cellx1446\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth2694\cellx4140\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth1962\cellx6102\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth3644\cellx9746\pard\s16\intbl\nowidctlpar\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080 Osteoporosis\cell Any risk factors for osteoporosis?\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Low trauma fracture\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Loss of height\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Thoracic kyphosis\par\plain\f2\fs26 r\plain\f0\fs24   \plain\f0\fs20 Low mobilisation\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Medication (eg long term steroids)\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  PHx eating disorder\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Chronic liver or renal disease\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Malabsorption\par\plain\f2\fs26 r\plain\f0\fs24   \plain\f0\fs20 Thyroid disease\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Inflammatory arthropathies\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Poor diet\par\plain\f2\fs26 r\plain\f0\fs24   \plain\f0\fs20 Excess alcohol/caffeine\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Limited sun exposure\par Women:\par\plain\f2\fs26 r\plain\f0\fs24   \plain\f0\fs20 history of > 6 months amenorrhoea \cell\plain\f2\fs26 r\plain\f0\fs24   \plain\f0\fs20 Average Risk\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  High Risk\par\cell Examples of intervention\par Advice on:\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Calcium, vitamin D\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Physical exercise\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  smoking/ alcohol/ caffeine\par\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Calcium and Vitamin D supplements\par\par Investigations if high risk, eg:\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  BMD\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Vitamin D levels\par\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  appointment to discuss bone health\cell\row\trowd\irow0\irowband0\trgaph100\trleft0\trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl100\trpaddr108\trpaddfl3\trpaddft3\trpaddfr3\trpaddfb3\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth1446\cellx1446\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth2694\cellx4140\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth1962\cellx6102\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth3644\cellx9746\pard\s16\intbl\nowidctlpar\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080\plain\f0\fs20 Diabetes\cell Use AUSDRISK Tool to assess risk of developing type 2 diabetes.\par\par If you do not wish to use this tool check: \par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  History of raised BGL/ IGT/ Diabetes\par\plain\f2\fs26 r\plain\f0\fs24   \plain\f0\fs20 Family History of DM\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Overweight\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Sedentary lifestyle\par\plain\f2\fs26 r\plain\f0\fs24   \plain\f0\fs20 Ethnicity\par\plain\f2\fs26 r\plain\f0\fs24   \plain\f0\fs20 Women: gestational diabetes or large baby\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Women: PCOS\cell Intervention recommended?\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Yes\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  No\cell Examples of intervention\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20 Fasting blood glucose to confirm status \par\pard\s16\intbl\nowidctlpar\tx34\tx1196\plain\f2\fs26 r\plain\f0\fs20  Refer to Lifestyle Modification Program\par\pard\s16\intbl\nowidctlpar\tx35\tx319\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\plain\f2\fs26 r\plain\f0\fs20 Lifestyle risk factor counselling\par\pard\s16\intbl\nowidctlpar\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20 If DM appointment to discuss diabetes\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20 Refer to Diabetes Educator \par\plain\f2\fs26 r\plain\f0\fs20 Develop GPMP\par\plain\f2\fs26 r\plain\f0\fs20 Other\cell\row\trowd\irow1\irowband1\trgaph100\trleft0\trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl100\trpaddr108\trpaddfl3\trpaddft3\trpaddfr3\trpaddfb3\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth1446\cellx1446\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth2694\cellx4140\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth1962\cellx6102\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth3644\cellx9746\pard\s16\intbl\nowidctlpar\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080 Cholesterol/ Lipids\cell When was your cholesterol last tested?\par\cell Order Fasting Blood Lipids \par  \par Assess absolute cardiovascular risk\cell Examples of intervention\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Lifestyle risk factor counseling\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Pharmacotherapy if eligible\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  appointment to discuss lipids\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Other\cell\row\trowd\irow2\irowband2\trgaph100\trleft0\trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl100\trpaddr108\trpaddfl3\trpaddft3\trpaddfr3\trpaddfb3\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth1446\cellx1446\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth2694\cellx4140\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth1962\cellx6102\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth3644\cellx9746\pard\s16\intbl\nowidctlpar\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080 Kidney Function\cell Urinalysis\par Leuco:\par Protein:\par Blood:\par Other:\cell\cell Examples of intervention\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Further investigation\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Discuss renal function\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Other\cell\row\trowd\irow3\irowband3\trgaph100\trleft0\trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl100\trpaddr108\trpaddfl3\trpaddft3\trpaddfr3\trpaddfb3\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth1446\cellx1446\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth2694\cellx4140\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth1962\cellx6102\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth3644\cellx9746\pard\s16\intbl\nowidctlpar\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080 Bowel Cancer Screening\cell Are you aware of bowel cancer screening?\cell\cell Examples of intervention\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Information about Bowel Cancer Screening\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Other:\cell\row\trowd\irow4\irowband4\lastrow\trgaph100\trleft0\trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl100\trpaddr108\trpaddfl3\trpaddft3\trpaddfr3\trpaddfb3\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth1446\cellx1446\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth2694\cellx4140\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth1962\cellx6102\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth3644\cellx9746\pard\s16\intbl\nowidctlpar\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080 Other issues\cell\cell\cell\cell\row\pard\s16\itap0\nowidctlpar\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080\plain\f0\fs24\par\trowd\irow0\irowband0\lastrow\trgaph108\trleft0\trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfr3\trpaddfb3\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth9746\cellx9746\pard\s16\intbl\nowidctlpar\qc\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080\plain\f0\fs24\b ASSESSMENT FOR WOMEN ONLY\cell\row\trowd\irow0\irowband0\trgaph100\trleft0\trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl100\trpaddr108\trpaddfl3\trpaddft3\trpaddfr3\trpaddfb3\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth1287\cellx1287\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth2853\cellx4140\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth1962\cellx6102\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth3644\cellx9746\pard\s16\intbl\nowidctlpar\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080 Risk Factor\cell Information/ Questions\cell Assessment\cell Intervention/ advice/ information recommended:\cell\row\trowd\irow1\irowband1\trgaph100\trleft0\trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl100\trpaddr108\trpaddfl3\trpaddft3\trpaddfr3\trpaddfb3\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth1287\cellx1287\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth2853\cellx4140\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth1962\cellx6102\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth3644\cellx9746\pard\s16\intbl\nowidctlpar\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080\plain\f0\fs20 Cervical Cancer\par\par\cell When was you last pap test (if has intact uterus)?\par What was the result?\cell\cell Examples of intervention\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  If more than 2 years, make appointment for pap smear\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Other:\cell\row\trowd\irow2\irowband2\trgaph100\trleft0\trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl100\trpaddr108\trpaddfl3\trpaddft3\trpaddfr3\trpaddfb3\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth1287\cellx1287\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth2853\cellx4140\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth1962\cellx6102\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth3644\cellx9746\pard\s16\intbl\nowidctlpar\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080 Breast Screening\cell Are you aware of Breast Screen/ Mammogram screening?\cell\cell Examples of intervention\par\plain\f2\fs26 r\plain\f0\fs24   \plain\f0\fs20 Information about Breast Cancer\par\plain\f2\fs26 r\plain\f0\fs24   \plain\f0\fs20 Other:\cell\row\trowd\irow3\irowband3\lastrow\trgaph100\trleft0\trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl100\trpaddr108\trpaddfl3\trpaddft3\trpaddfr3\trpaddfb3\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth1287\cellx1287\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth2853\cellx4140\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth1962\cellx6102\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth3644\cellx9746\pard\s16\intbl\nowidctlpar\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080 Other relevant issues\cell\cell\cell\cell\row\pard\s16\itap0\nowidctlpar\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080\plain\f0\fs24\par\trowd\irow0\irowband0\lastrow\trgaph108\trleft0\trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfr3\trpaddfb3\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth9746\cellx9746\pard\s16\intbl\nowidctlpar\qc\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080\plain\f0\fs24\b ASSESSMENT FOR MEN ONLY\cell\row\trowd\irow0\irowband0\trgaph100\trleft0\trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl100\trpaddr108\trpaddfl3\trpaddft3\trpaddfr3\trpaddfb3\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth1287\cellx1287\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth2689\cellx3976\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth2126\cellx6102\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth3644\cellx9746\pard\s16\intbl\nowidctlpar\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080 Risk Factor\cell Information/ Questions\cell Assessment\cell Intervention/ recommendation:\cell\row\trowd\irow1\irowband1\trgaph100\trleft0\trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl100\trpaddr108\trpaddfl3\trpaddft3\trpaddfr3\trpaddfb3\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth1287\cellx1287\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth2689\cellx3976\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth2126\cellx6102\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth3644\cellx9746\pard\s16\intbl\nowidctlpar\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080\plain\f0\fs20 Prostate Cancer\par\cell Family History?\par Urine Symptoms?\cell\cell Examples of intervention\par\plain\f2\fs26 r\plain\f0\fs24   \plain\f0\fs20 Information about Prostate Cancer\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Other:\cell\row\trowd\irow2\irowband2\lastrow\trgaph100\trleft0\trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl100\trpaddr108\trpaddfl3\trpaddft3\trpaddfr3\trpaddfb3\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth1287\cellx1287\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth2689\cellx3976\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth2126\cellx6102\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth3644\cellx9746\pard\s16\intbl\nowidctlpar\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080 Other relevant issues\cell\cell\cell\cell\row\pard\s16\itap0\nowidctlpar\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080\plain\f0\fs24\par\trowd\irow0\irowband0\lastrow\trgaph108\trleft0\trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfr3\trpaddfb3\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth9720\cellx9720\pard\s16\intbl\nowidctlpar\qc\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080\plain\f0\fs24\b EXAMINATION\cell\row\trowd\irow0\irowband0\trgaph100\trleft0\trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl100\trpaddr108\trpaddfl3\trpaddft3\trpaddfr3\trpaddfb3\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth1980\cellx1980\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth3780\cellx5760\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth3960\cellx9720\pard\s16\intbl\nowidctlpar\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080 Examine\cell Significant Findings\cell Intervention required:\cell\row\trowd\irow1\irowband1\lastrow\trgaph100\trleft0\trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl100\trpaddr108\trpaddfl3\trpaddft3\trpaddfr3\trpaddfb3\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth1980\cellx1980\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth3780\cellx5760\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth3960\cellx9720\pard\s16\intbl\nowidctlpar\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080\plain\f0\fs20 Blood Pressure\par\par\cell Systolic\par Diastolic\par\par Aim:\cell Examples of intervention\par\plain\f2\fs26 r\plain\f0\fs24   A\plain\f0\fs20 ssess absolute cardiovascular risk\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Lifestyle risk factor counseling\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Pharmacotherapy if eligible\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Other\cell\row\trowd\irow0\irowband0\trgaph100\trleft0\trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl100\trpaddr108\trpaddfl3\trpaddft3\trpaddfr3\trpaddfb3\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth1980\cellx1980\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth3780\cellx5760\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth3960\cellx9720\pard\s16\intbl\nowidctlpar\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080\plain\f0\fs20 Skin examination for skin cancer and pre-cancerous lesion\cell\cell Examples of intervention\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Lifestyle counseling re sun exposure\par\plain\f2\fs26 r\plain\f0\fs24   A\plain\f0\fs20 ppointment for biopsy/ excision\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Referral\par\plain\f2\fs26 r\plain\f0\fs24   \plain\f0\fs20 Other:\cell\row\trowd\irow1\irowband1\trgaph100\trleft0\trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl100\trpaddr108\trpaddfl3\trpaddft3\trpaddfr3\trpaddfb3\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth1980\cellx1980\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth3780\cellx5760\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth3960\cellx9720\pard\s16\intbl\nowidctlpar\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080 Weight\cell Height:\par Weight:\par BMI:\par Waist circumference:\cell Add values to weight management above\cell\row\trowd\irow2\irowband2\lastrow\trgaph100\trleft0\trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl100\trpaddr108\trpaddfl3\trpaddft3\trpaddfr3\trpaddfb3\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth1980\cellx1980\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth3780\cellx5760\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth3960\cellx9720\pard\s16\intbl\nowidctlpar\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080 Other relevant issues\cell\cell\cell\row\pard\s16\itap0\nowidctlpar\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080\plain\f0\fs16\par\plain\f0\fs24\b\ul Follow up appointment with results:\par\plain\f0\fs16\par\trowd\irow0\irowband0\lastrow\trgaph108\trleft0\trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfr3\trpaddfb3\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth9746\cellx9746\pard\s16\intbl\nowidctlpar\qc\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080\plain\f0\fs28\b SUMMARY OF RESULTS\cell\row\trowd\irow0\irowband0\trgaph100\trleft0\trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl100\trpaddr108\trpaddfl3\trpaddft3\trpaddfr3\trpaddfb3\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth1287\cellx1287\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth2689\cellx3976\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth2126\cellx6102\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth3644\cellx9746\pard\s16\intbl\nowidctlpar\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080\plain\f0\fs22\b Test\cell Result\cell Normal? \cell Intervention required:\cell\row\trowd\irow1\irowband1\trgaph100\trleft0\trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl100\trpaddr108\trpaddfl3\trpaddft3\trpaddfr3\trpaddfb3\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth1287\cellx1287\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth2689\cellx3976\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth2126\cellx6102\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth3644\cellx9746\pard\s16\intbl\nowidctlpar\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080\plain\f0\fs20 Fasting Glucose\par\par\cell\cell\cell Examples of intervention\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Further investigations \par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Lifestyle risk factor counseling\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Appointment to discuss diabetes/ impaired glucose tolerance\cell\row\trowd\irow2\irowband2\trgaph100\trleft0\trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl100\trpaddr108\trpaddfl3\trpaddft3\trpaddfr3\trpaddfb3\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth1287\cellx1287\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth2689\cellx3976\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth2126\cellx6102\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth3644\cellx9746\pard\s16\intbl\nowidctlpar\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080 Fasting Lipids\cell Total Cholesterol:\par Triglycerides:\par HDL:\par LDL:\cell\cell Examples of intervention\par\plain\f2\fs26 r\plain\f0\fs24   \plain\f0\fs20 Lifestyle risk factor counseling\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Pharmacotherapy if eligible\par\plain\f2\fs26 r\plain\f0\fs24   A\plain\f0\fs20 ppointment to discuss lipids\par\plain\f2\fs26 r\plain\f0\fs24  \plain\f0\fs20  Other\cell\row\trowd\irow3\irowband3\lastrow\trgaph100\trleft0\trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl100\trpaddr108\trpaddfl3\trpaddft3\trpaddfr3\trpaddfb3\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth1287\cellx1287\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth2689\cellx3976\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth2126\cellx6102\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clftsWidth3\clwWidth3644\cellx9746\pard\s16\intbl\nowidctlpar\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080 Other \par\cell\cell\cell\cell\row\pard\itap0\nowidctlpar\qj\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080\par }