ࡱ> IKH B7bjbj .>VV8$ fxxx(******n*-xxxxx*Wx^(x(b^m04Btxxxxxxx**v*xxxxxxxxxxxxxxxxV _: PHYSICAL EXAM Date of Exam ___ / ___ / ___ SITENOT EXAMINEDNormalAbnormal ( If abnl, is it Clinically Significant?)IF ABNORMAL, DESCRIBEGeneral Appearance%%% CS % YES % NO HEENT %%% CS % YES % NO Chest & Lungs %%% CS % YES % NO Heart %%% CS % YES % NO Abdomen %%% CS % YES % NO Musculoskeletal %%% CS % YES % NO Skin %%% CS % YES % NO Lymph nodes %%% CS % YES % NO Neurological %%% CS % YES % NO Other: %%% CS8VZ~F L N P b f ( * N P R T V X j n 0 ƺƺưڤژƌƌڤڤژƌڤڤژƌڤڤژƌhDDdhd5CJaJhDDdhd5CJ aJ hDDdhd5CJ$aJ$hDDdhd56hDDdh5CJaJhDDdhd5CJaJhDDdh5hDDdhd5 hd5hs hd5h=Nhd5>* hd5>*7XZdl~  $$Ifa$gdDDd $Ifgdd`gdd $`a$gdd @ ^@ `gdd  0 F J N r JAA55A $$Ifa$gdDDd $Ifgddkd$$IflrL\ (#8 t0#44 laytDDdr Akd$$IfllrL\ (#8 t0#44 laytDDd $Ifgdd * , . $Ifgdd $$Ifa$gdDDd. 0 L N R V z JAA55A $$Ifa$gdDDd $Ifgddkd$$IflhrL\ (#8 t0#44 laytDDdz 7kd$$IflrL\ (#8 t0#44 laytDDd $$Ifa$gdDDd $Ifgdd 2 4 6 $Ifgdd $$Ifa$gdDDd0 2 J L N P R T f j @ B T V X Z \ ^ p t B D f h j l n p ºhDDdh5CJaJhDDdh5CJaJhDDdh5CJ aJ hDDdh5CJ$aJ$hDDdh5 hg5hDDdhd5CJaJhDDdhd5CJ aJ hDDdhd5CJ$aJ$hDDdhd5hDDdhd5CJaJ66 8 H J N R v LCC77C $$Ifa$gdDDd $IfgddkdT$$IflrL\ (#8 t0#44 laytDDdv 7. $IfgdDDdkd&$$IflrL\ (#8 t0#44 laytDDd $$Ifa$gdDDd $Ifgdd  B D F $Ifgdd $$Ifa$gdDDd $IfgdDDdF H R T X \ LCC77 $$Ifa$gdDDd $IfgdDDdkd$$IflrL\ (#8 t0#44 laytDDd\ 7kd$$IflrL\ (#8 t0#44 laytDDd $$Ifa$gdDDd $Ifgdd  D F H $Ifgdd $$Ifa$gdDDd $IfgdDDdH J d f j n LCC77 $$Ifa$gdDDd $IfgdDDdkd$$IflrL\ (#8 t0#44 laytDDdn 7kdn$$IflrL\ (#8 t0#44 laytDDd $$Ifa$gdDDd $Ifgdd 44J4L4R444b5n5r5v555555555555666 6:66666sgh1CJOJQJaJhh5CJOJQJaJhhCJOJQJaJh0Xjh5CJOJQJaJh^tjh^tUhrfhd h5 h15 hd5hDDdh5CJaJhDDdh5CJaJUhDDdh5CJ aJ hDDdh5hDDdh5CJ$aJ$% 4L4N4P4 $Ifgdd $$Ifa$gdDDd % YES % NO  COMMENTS: __________________________________________________________ _______________________________________________________________________ PI SIGNATURE: __________________________ Date _____________     University of Rochester Subject Initials __________ Subject Number _________ Date _______ Protocol #: _________________________ 15-Apr-13 P4R4T444p5r55LC>C>C>gd`gddkd@$$IflrL\ (#8 t0#44 laytDDd5555555666 6:666"7$7<7>7@7B7gddgddgd$a$gd0Xjgdd6667 7$7(7:7>7@7B7ʾhrfh^thTkshPh5Eh5ECJaJhhT(CCJOJQJaJh0XjCJOJQJaJhh5ECJOJQJaJ ,1h/ =!"#$% $$If!vh555855 #v#v#v8#v#v :V l t0#555855 ytDDd$$If!vh555855 #v#v#v8#v#v :V ll t0#555855 ytDDd$$If!vh555855 #v#v#v8#v#v :V lh t0#555855 ytDDd$$If!vh555855 #v#v#v8#v#v :V l t0#555855 ytDDd$$If!vh555855 #v#v#v8#v#v :V l t0#555855 ytDDd$$If!vh555855 #v#v#v8#v#v :V l t0#555855 ytDDd$$If!vh555855 #v#v#v8#v#v :V l t0#555855 ytDDd$$If!vh555855 #v#v#v8#v#v :V l t0#555855 ytDDd$$If!vh555855 #v#v#v8#v#v :V l t0#555855 ytDDd$$If!vh555855 #v#v#v8#v#v :V l t0#555855 ytDDd$$If!vh555855 #v#v#v8#v#v :V l t0#555855 ytDDd^ 02 0@P`p2( 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p8XV~_HmH nH sH tH @`@ dNormalCJ_HaJmH sH tH DA D Default Paragraph FontRi@R  Table Normal4 l4a (k (No List jj d Table Grid7:V04@4 dHeader  !4 @4 d0Footer  !.)!. d Page Number616 P0 Footer CharCJaJHBH P Balloon TextCJOJQJ^JaJNQN PBalloon Text CharCJOJQJ^JaJPK![Content_Types].xmlj0Eжr(΢Iw},-j4 wP-t#bΙ{UTU^hd}㨫)*1P' ^W0)T9<l#$yi};~@(Hu* Dנz/0ǰ $ X3aZ,D0j~3߶b~i>3\`?/[G\!-Rk.sԻ..a濭?PK!֧6 _rels/.relsj0 }Q%v/C/}(h"O = C?hv=Ʌ%[xp{۵_Pѣ<1H0ORBdJE4b$q_6LR7`0̞O,En7Lib/SeеPK!kytheme/theme/themeManager.xml M @}w7c(EbˮCAǠҟ7՛K Y, e.|,H,lxɴIsQ}#Ր ֵ+!,^$j=GW)E+& 8PK!Ptheme/theme/theme1.xmlYOo6w toc'vuر-MniP@I}úama[إ4:lЯGRX^6؊>$ !)O^rC$y@/yH*񄴽)޵߻UDb`}"qۋJחX^)I`nEp)liV[]1M<OP6r=zgbIguSebORD۫qu gZo~ٺlAplxpT0+[}`jzAV2Fi@qv֬5\|ʜ̭NleXdsjcs7f W+Ն7`g ȘJj|h(KD- dXiJ؇(x$( :;˹! I_TS 1?E??ZBΪmU/?~xY'y5g&΋/ɋ>GMGeD3Vq%'#q$8K)fw9:ĵ x}rxwr:\TZaG*y8IjbRc|XŻǿI u3KGnD1NIBs RuK>V.EL+M2#'fi ~V vl{u8zH *:(W☕ ~JTe\O*tHGHY}KNP*ݾ˦TѼ9/#A7qZ$*c?qUnwN%Oi4 =3ڗP 1Pm \\9Mؓ2aD];Yt\[x]}Wr|]g- eW )6-rCSj id DЇAΜIqbJ#x꺃 6k#ASh&ʌt(Q%p%m&]caSl=X\P1Mh9MVdDAaVB[݈fJíP|8 քAV^f Hn- "d>znNJ ة>b&2vKyϼD:,AGm\nziÙ.uχYC6OMf3or$5NHT[XF64T,ќM0E)`#5XY`פ;%1U٥m;R>QD DcpU'&LE/pm%]8firS4d 7y\`JnίI R3U~7+׸#m qBiDi*L69mY&iHE=(K&N!V.KeLDĕ{D vEꦚdeNƟe(MN9ߜR6&3(a/DUz<{ˊYȳV)9Z[4^n5!J?Q3eBoCM m<.vpIYfZY_p[=al-Y}Nc͙ŋ4vfavl'SA8|*u{-ߟ0%M07%<ҍPK! ѐ'theme/theme/_rels/themeManager.xml.relsM 0wooӺ&݈Э5 6?$Q ,.aic21h:qm@RN;d`o7gK(M&$R(.1r'JЊT8V"AȻHu}|$b{P8g/]QAsم(#L[PK-![Content_Types].xmlPK-!֧6 +_rels/.relsPK-!kytheme/theme/themeManager.xmlPK-!Ptheme/theme/theme1.xmlPK-! ѐ' theme/theme/_rels/themeManager.xml.relsPK]  > 0 6B7 r . z 6 v F \ H n P45B7 8@0(  B S  ?TXOS3-?EGNOaklvy$*an))ciiru?EGNaklv$*an))ciiru[#.#186T(C5EDDd^d0XjTks^trf+P9d115*(30g@(`` `4UnknownG*Ax Times New Roman5Symbol3. *Cx Arial7.@Calibri5. .[`)TahomaA$BCambria Math"1hk[IK'FK' bb!42QHP ?152!xx PHYSICAL EXAMUser Kathleen WessmanOh+'0 $ D P \ ht|PHYSICAL EXAMUser NormalKathleen Wessman7Microsoft Office Word@H'@y~@R6@Fb՜.+,0 hp|   PHYSICAL EXAM Title !"#$%&')*+,-./012345679:;<=>?ABCDEFGJRoot Entry FPbLData  1Table(WordDocument.>SummaryInformation(8DocumentSummaryInformation8@CompObjy  F'Microsoft Office Word 97-2003 Document MSWordDocWord.Document.89q