Rehabilitation Screen Side-Punch Form

$40.00
In stock
Product Code :
MPSBRG-CFS10-1HH
More Information
Color White
MPN CFS10-1HH
Brand Briggs Health Care
Packaging 1 per each
Size 8 1/2 x 11

Note : Image shown for reference purposes only. Actual product appearance may vary. Please read product description for full and accurate details.

Each therapist records his/her recommendations on the back of the form.

This rehabilitation screening form is used to determine the appropriate level of resident care and whether rehabilitative services need to be provided by the therapy staff (physical therapy, occupational therapy, speech therapy), nursing staff or rehabilitative nursing staff.
  • 8 1/2 x 11
  • white paper
  • black ink
  • printed two sides different
  • 5-hole side punched
  • padded in 100s
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