*Hospital Management Guidelines – ATS
Hospital Management Guidelines for Patients with Andersen-Tawil Syndrome Patient’s Name: ___________________________________________________ Birthdate: ______________________Height: _____________Weight: _____________ Address: _____________________________________________________________ ______________________________________________________________________ Primary Physician: ___________________________________________________ Physician Phone: ___________________________ FAX:__________________________ Emergency contact: Name ___________________________________________ Relationship: ________________________________________________________ home phone# ___________________cell # _____________________________ PRECAUTIONS: Place patient in coma position to…