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Account Profile Log

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General Facility Information

Video used:

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Shaver used:

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Pump used:

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Radio Frequency used:

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Primary Shoulder Instrumentation used:

Select one
Primary F&A Instrumentation used:

Select one
Primary Hip Instrumentation used:

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Positioning Equipment
Select all that apply
Central Sterile Personnel & Position
Name
Position
 
Key Scrub Techs & What Surgeons They Work With
Scrub Tech
Surgeon
 
Administration & Position
Name
Position
 
Weekly Block Surgery Schedule
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
 

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