Counseling African Americans To Control Hypertension (Caatch) Study Page 4

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Vital Signs: Collect all Blood Pressure from today to 6 months prior to consent date
st
nd
rd
Date
Taken By
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3
Heart Rate Weight (lbs)
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2
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4
5
SBP / DBP
SBP / DBP
SBP / DBP
/
/
MD NP/PA RN MA RC
NN
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bpm
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MD NP/PA RN MA RC
NN
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bpm
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MD NP/PA RN MA RC
NN
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bpm
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MD NP/PA RN MA RC
NN
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bpm
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MD NP/PA RN MA RC
NN
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bpm
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MD NP/PA RN MA RC
NN
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bpm
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MD NP/PA
RN MA RC
NN
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bpm
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MD NP/PA
RN MA RC
NN
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bpm
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MD NP/PA RN MA RC
NN
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bpm
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MD NP/PA RN MA RC
NN
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bpm
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MD NP/PA RN MA RC
NN
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bpm
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MD NP/PA RN MA RC
NN
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bpm
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MD NP/PA RN MA RC
NN
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bpm
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MD NP/PA RN MA RC
NN
/
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bpm
/
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MD NP/PA
RN MA RC
NN
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bpm
/
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MD NP/PA
RN MA RC
NN
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bpm
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MD NP/PA RN MA RC
NN
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bpm
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MD NP/PA RN MA RC
NN
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bpm
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MD NP/PA RN MA RC
NN
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bpm
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MD NP/PA RN MA RC
NN
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bpm
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MD NP/PA RN MA RC
NN
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bpm
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MD NP/PA RN MA RC
NN
/
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bpm
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MD NP/PA RN MA RC
NN
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bpm
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MD NP/PA RN MA RC
NN
/
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/
bpm
Study ID
Site #
Reviewer ID
G:CAATCHAssessmentsChart Review
4

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