All clinicians are required by law to accurately document the complete details of every patient encounter and patient-related encounter, including:

a. Patient's education level.
b. Patient's salary.
c. Patient's reason for the encounter.
d. Patient's complete health history.


Answer: c
Feedback: Reasons for encounter is one of the elements of complete documentation. Education and salary level are not required. Typically some history is required, but a complete history is not required.

Health Professions

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