VA_Inhaler_Tool_20180306_pages

COPD home plan

Date

Patient name

MRN

Doctor's name

Phone number

Short-term specialty care for COPD The ROLD clinic The ROLD Clinic is designed for patients who were recently discharged from the hospital following a COPD flare up.

hospitalization

routine care

special COPD care

Work towards your COPD care goals until your next appointment

1 A B C Other notes

Follow up with the ROLD clinic in ___ weeks. Date & time of next appointment:

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