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Chilliwack General Hospital (CGH) Arthroplasty Clinic 2017 - Joint Replacement - Hips and knees

I was asked by The Chilliwack division of Family Practice to make this form. There is a BMI calculator, there are some drop down lists. There is a circle function for Male/Female that automatically circles the appropriate one. It checks to see if they are a smoker and checks that box ( it checks both measurements SKST and SMK - why are there 2 again?) If one says yes and one says no it will check off that the patient is a smoker. It will pull the HbA1c if there is a value in the chart (and if it is mapped, but I think A1c mapping is standard). It will also check off the A1c box if the value for A1c is >0. There are also some radio X boxes. JohnR.

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