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This consent is maintained in coming off trileptal trileptal level monitoring trileptal dosage for children trileptal dosage for the client’s record and is accessible to authorized users .
Name – Patient / Client (Last, First MI) Name – Individual Preparing This Form Name – Staff Contact MEDICATION CATEGORY DAILY TOTAL DOSAGE RANGE Name / Telephone Number – Institution The anticipated dosage range is to be individualized, may be above or below the recommended range but no medication will be administered trileptal without your informed and written consent .
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This medication will be administered Other trileptal – Specify: 1 .
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Environment and/or staff changes Rehabilitation treatments/therapy (OT, trileptal level monitoring trileptal liquid bipolar medication trileptal trileptal side effects PT, AT) Positive redirection and staff interaction Treatment programs and approaches (habilitation) Individual and/or group therapy Use of behavior intervention techniques Other Alternatives: 3 .

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