| # | Name | Location | Type | Details | Index | Description |
|---|---|---|---|---|---|---|
| .01 | health statement,colleague | 0;1 | DATE-TIME | B | This field allows you to enter the date on which the Statement of Health Status was received from a colleague of the practitioner. Individuals from which this could be received include the Chief of Staff, Chief of Service, Training Program Director, or a peer. |
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