English	French	Notes	Complete/Exclude
salivary glands			
range of motion			
pain or tenderness			
nipple discharge			
Musculoskeletal - spine,upper and lower extremeties:			
mobility, tenderness, pain of spine			
joint pain			
joint swelling			
muscle weakness			
rheumatic fever			
shortness of breath			
pulmonary embolus			
configuration of thorax			
respiratiory movements			
inspiratory breath sounds			
expiratiory breath sounds			
heart inpulse			
chest pain/discomfort			
paroxysmal nocturnal dyspnea			
neck veins			
peripheral veins			
nausea and vomiting			
abdominal wall/distention/tenderness			
food intolerance			
bowel sounds			
ventral hernia			
gastric/marginal/duodenal ulcer			
urinary infection			
veneral disease			
inguinal canal			
Female:			
external genitalia			
abnormal menses			
vaginal discharge			
anus and sphincter			
test for occult blood			
MENTAL DISORDERS - POW PROTOCOL			
Physician's Guide Reference:  Chapter 14, 17, 20			
1. Immediate pre-military events -			
2. Events as a POW -			
traumatic events as a POW, if not elsewhere			
SOCIAL WORK SURVEY - POW PROTOCOL			
Physician's Guide Reference:  Chapter 17			
A. Describe the veteran's personal appearance -			
B. Describe the veteran's personal health -			
C. Describe the veteran's family adjustment -			
D. Describe the veteran's community adjustment -			
E. Describe the veteran's economic adjustment -			
cranial nerves			
gait disturbance			
biceps reflex			
triceps reflex			
patellar reflex			
Achilles reflex			
plantar response			
peripheral nerves			
sensory change			
loss of consciousness			
memory change			
trouble with decisions			
sleep disturbance			
crying spells			
thoughts of suicide			
difficulty with work			
loss of appetite			
trouble with sex life			
social withdrawal			
improbable beliefs			
C. Summary of findings:			
PRISONER OF WAR PROTOCOL			
A. Medical history (include childhood and adult illnesses and			
B. Past history (include civilian and military occupation, military)			
history including geographic locations and dates, habits			
such as alcohol, tobacco and drugs, family history):			
C. System review (comment specifically if positive symptom):			
weight change			
fever or chills			
night sweats			
irritable bowel syndrome			
peptic ulcer			
PYELITIS, NEPHROLITHIASIS, URETEROLITHIASIS,			
URETERAL STRICTURE AND HYDRONEPHROSIS (GU)			
4. Catheter drainage requirement (frequency of need) -			
RECTUM AND ANUS (DIGESTIVE)			
Diseases of the rectum, anal canal or perineum must be			
differentiated as to type.			
8. Fecal leakage -			
9. Frequency of episodes -			
EDIT C&P STATIC INFORMATION			
The status of this request is not NEW or PENDING, REPORTED.			
It cannot, therefore, be modified.			
Since you have modified the REMARKS section,			
a new copy of the request will be issued to the			
medical center tomorrow morning.			
1,3,0,2:1,0^Insufficient link info not updated!...Priority restored			
Invalid user number (DUZ)			
DVBA C RELEASE 2507			
You are not authorized to release 2507 requests!!			
 is not complete 			
2507 Exam Release			
Please wait while the individual exam statuses are checked.  			
All exams have been completed, please enter the following:			
Since there are still incomplete exams,			
  this request cannot be released to the RO.  			
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This request is now released.			
Release NOT COMPLETED !!			
This request has been cancelled by the RO.			
This request has been completed and transferred out.			
This request has been cancelled by MAS.			
This request has been released to the RO.			
This request has been printed by the RO.			
This request is new and has not yet been reported to MAS.			
COMPENSATION AND PENSION EXAM REQUEST			
Requested by 			
0,0,0,2:1,0^** Priority of exam: 			
0,0,0,0,0^Date original 2507 Reported to MAS: 			
0,0,0,3:2,0^Selected exams: 			
Current Rated disabilities:			
General remarks:			
Unknown division			
 Medical Center Division at 			
*** Transferred from 			
Date Requested: 			
** Claim folder review will be required **			
VA Form 21-2507			
General remarks (continued):			
No parameters in AMIE site parameter file!			
New 2507 Request Report for 			
BDTRQ*			
EDTRQ*			
New Request Recap Sheet for Run Date 			
C&P Diagnostic Test Order Record			
Initials			
Laboratory:			
Radiology:			
Other:			
Missing vet name			
Manual New C&P Request Printing			
Do you want just one request			
Enter Y for only one Vet or N for all Vets.			
Enter BEGINNING date of request: 			
     and ENDING date of request: 			
Ending date is earlier than starting date!			
New C&P request printing			
New C&P Requests -- 			
There were no new 2507 requests for 			
for division 			
C&P Request Modifications -- 			
No modified requests to report.			
C&P Exams Added -- 			
No added exams to report.			
Date of request: 			
Enter MED CENTER DIVISION: 			
C&P REQUESTS BY DATE RANGE			
Enter DATE OF REQUEST FROM: 			
Do you want to report by physician			
Enter <Y> to report by Physician or <N> to report only by date range.			
This report uses 			
by Physician			
by Date Range			
EXAMINING PHYSICIAN			
RESPIRATORY MANIFESTATIONS OF DISEASES OF OTHER SYSTEMS			
An example of this type of exam is extremely unfavorable			
ankylosis of the thoracic spine that so severely			
restricts chest excursion that the veteran is dyspneic			
on minimal exertion OR abdominal tumor interferes with			
excursion of the diaphragm to such an extent that chronic			
passive congestion of one lung results.			
C. Objective findings :			
1. Clinical findings -			
2. Pulmonary function studies -			
Since this request has reopened, its status will			
be PENDING, REPORTED.			
Be sure to regenerate any exam worksheets that will be needed			
for this request.			
Press RETURN to continue 			
Your user number (DUZ) is invalid !			
Re-open Exams/Requests			
Status prohibits activity except by supervisors.			
1,0,0,2,0^This 2507 was never reported to MAS, it can NOT be reopened.			
Do you want to reopen the ENTIRE request			
Enter Y to reopen the ENTIRE request or N to reopen only selected exams.			
Select EXAM TO REOPEN: 			
Exam name not found in file 396.6 !			
Already open!			
   reopen error !			
There are no cancelled or completed exams remaining on this request.			
Reopen error on 			
Entire exam is now REOPENED.			
Reopen error !			
Sending a bulletin to the 2507 REOPENED mail group ...			
DVBA C 2507 EXAM REOPENED			
This request has not been released.			
     This reopen will not affect the AMIE AMIS 290.			
     **THIS REOPEN WILL AFFECT THE AMIE AMIS 290**			
/Affects AMIE AMIS 290			
G.DVBA C 2507 EXAM REOPENED@			
I am sending updated information to 			
Select Reprint Option - (D)ate or (V)eteran:  D// 			
Must be D or V			
Do you want just the Lab/X-ray results			
Enter Y to get just the Lab/X-ray results for the Vet			
or N to get the entire exam results AND Lab/X-ray.			
Enter original printing date: 			
Reprinted by the RO or MAS ?   >> 			
Must be R for Regional Office or M for MAS.			
2507 Final Exam Reprint			
Single 2507 Final Exam Reprint			
** REPRINT OF FINAL **			
Physician signature: ___________________________________     Date: _____________			
SCARS, OTHER THAN BURNS (ORTHOPEDIC/DISFIGUREMENT)			
The type of injury or infection causing the wound or scar,			
its date, the treatment used and the response to such			
treatment should be described.  Point of entrance and exit of			
missiles are important 			
in evaluating injuries of nerves, vessels,			
and muscles.  Photographs, if indicated, (see Physician's Guide,			
Paragraph 1.19) should be submitted.			
2. Keloid formation, adherance, herniation -			
3. Inflammation, swelling, depression, vascular supply, ulceration -			
4. Tender and painful on objective demonstration -			
5. Cosmetic effects (submit photographs of all facial			
and other significant scars) -			
6. Limitation of function of part affected -			
SCHEDULE C&P EXAMS			
You have no user number !			
This request has no exams on it and should			
be completely cancelled.			
This request has been completely transferred to another site.			
Scheduling will not be allowed.			
Scheduling has been completed for this request as of 			
Only supervisors can change it.			
Do you want to change			
Enter Y to be able to change the scheduling information or N to backup.			
Note:  One or more exams on this request have transferred out.			
Do you want to make an appointment for a clinic			
Schedule a Clinic Appointment for 2507 Exam			
Enter Y to make an appointment via ADT/Scheduling or N to skip.			
Enter Scheduling Information for 2507 Exams			
Has scheduling for all exams been completed			
Enter Y if scheduling is completed, N if not.			
Ok, then please complete the following:			
Important scheduling information is missing!			
2507 file NOT updated!			
For SKIN, NOT ELSEWHERE CLASSIFIED			
Type of Exam: SKIN, NOT ELSEWHERE CLASSIFIED			
SKIN, OTHER THAN SCARS			
When furnishing the history of the present skin disease			
include a description of the skin changes, when the disorder			
first appeared, and the progression of the illness since that			
time.  Note whether			
 remissions or exacerbations occurred			
and whether they were related to the occupation or treatment.			
Include the duration of remissions and factors that			
may have influenced the course of the disorder.			
B. Subjective complaints:  			
(List the types of complaints such as itching			
burning, pain and anesthesia.  Note whether environmental factors such as			
temperature or seasonal change affect the severity of the symptoms.)			
1. Description of skin disorder -			
2. Distribution of skin disorder -			
3. Configuration and characteristics of lesions -			
4. Nervous manifestations -			
5. Attach color photograph if condition is disfiguring.			
(Note:  If current diagnosis differs from the skin condition			
for which the examination was ordered, then review prior records and			
express opinion whether current disease is a new problem or original 			
diagnosis was in error.)			
SENSE OF SMELL			
Report whether loss is partial or complete and whether it			
is on an organic or psychiatric basis.  If a psychiatric			
basis is suspected, a special psychiatric examination should			
be ordered.			
Substances used for testing olfaction and results (each side of nose			
should be tested separately):			
4. Oil of lemon -			
5. Other (state substance) -			
SPINE (ORTHOPEDIC)			
Complete description of spinal orthosis, its impact on			
motion before and after application, and whether the 			
usage is constant or intermittent should be part of the			
To give uniformity in 			
describing limitation of motion or			
ankylosis, THE USE OF A GONIOMETER IS REQUIRED.  Report			
each spinal segment separately.			
1. Postural abnormalities -			
2. Fixed deformity -			
3. Musculature of back -			
4. Range of motion:			
a. Forward flexion -			
b. Backward extension -			
c. Left lateral flexion -			
d. Right lateral flexion -			
e. Rotation to left -			
f. Rotation to right -			
5. Objective evidence of pain on motion -			
6. Identify and describe any evidence of neurological involvement -			
SCARS, BURN			
When true third degree burn involvement is established,			
measure and describe all areas of scarring and all secondary			
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