Page 5 - Norco Patient Orientation Handbook e-book
P. 5

A Norco representative has provided me with this Patient Orientation Handbook and has
                   given training on the equipment and/or service being provided at this time.

                   ______________________________            _____________________
                   Patient Name                               Account #

                   ______________________________            _____/_____/__________
                   Patient/Caregiver                                            Date

                   ______________________________            _____/_____/__________
                   Norco Employee                                             Date
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