Ausgrid Clinic Data Form
Consult
Initial
Follow-up
No show
Depot
Zetland
Oatley
Homebush
Gosford
Noraville
Muswellbrook
Workgroup
UG
OH
ESO
Poles
CC
AA
Other
Body area
Lumbar
Thoracic
Cervical
Shoulder
Arm/hand
Hip/knee
Foot/Ankle
Other
Duration of symptoms
< Week
< Fortnight
< Month
< 3 months
< 6 months
< 12 months
> 1 year
Relatedness
Work related
Work aggrevated
Non-work related
Submit Form
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