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Comprehensive Care Plan PROCEDURE DETAILS NAME

TYPE OF PROCEDURE(S)

DATE OF BIRTH

SURGEON

POA

HOSPITAL

Health

Ph#/Address

Finance

Length of Stay

INSURANCE

REHAB LOCATION

CO-PAY

REHAB DATES

ADVANCE DIRECTIVES

POST SURGERY MEDICATIONS

¨ POA for health

¨ POA for finance

Pain

¨ Living Will

¨ Other

Antibiotic

HOME HEALTH

FOLLOW-UP APPOINTMENT

OTHER SERVICES

EXPECTED RETURN TO NORMAL ACTIVITY

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Download additional copies of this worksheet at lgbtagingcenter.org/careplanning.

Profile for SAGE

SAGE Care Plan Workbook  

This workbook provides a detailed overview of what to expect when undergoing a surgical procedure, and how to plan for a successful recovery...

SAGE Care Plan Workbook  

This workbook provides a detailed overview of what to expect when undergoing a surgical procedure, and how to plan for a successful recovery...

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