Scheduling Worksheet

S:\HSC\HSC-STAFF\HSC-Business-Office\HSC-Forms\2017-HSC Forms\HSC-2017-Electronic-Scheduling-Worksheet (2).doc Rev 7.17 Scheduling Worksheet (CRMD) card when scheduling. For patient safety we need the make and model so we can notify the representative to be here during the procedure. ICD-10 Codes: If using Injury Diagnosis Code, need injury date