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United Family Medical Center

Adult Health Assessment Record

Procedure Date Date Date Date Date


1 Complete Lab
2 EKG
3 CXR
4 Abdominal Ultrasound
5 Renal Ultrasound
6 Pelvic Ultrasound
7 Thyroid Ultrasound
8 Prostate Ultrasound
9 Carotid Duplex Scan
10 Arterial and Venus Doppler
11 MSK Ultrasound
12 PAP Smear
13 Mammogram
14 Bone Mineral Density
15 Stress Echo
16 Echo Doppler
17 Holter Monitor
18 Endoscopy/EGD
19 Colonoscopy
20 Foot Exam
21 Tetanus Toxoid
22 Mantoux
23 Flu Vaccine
24 Arthritis Panel
25 Lipid Panel
26 A1C

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