Transmittal Notice 67-80
The attached Appendix XII is to be included in the Indian Health Manual directly behind XI under Part 3, Chapter 4, Nursing. It contains instructions for the use of the following forms.
PHS-4909-1 Nursing Personnel - Record of Staff Education.
PHS-4909-2 Nursing Personnel - Record of Patient Teaching.
PHS-4909-3 Nursing Personnel - Evaluation
/E.S. Rabeau, M.D./
E.S. Rabeau, M.D.
Assistant Surgeon General
Director, Division of Indian Health
Appendix XII, Part 3, Chapter 4, Nursing.
File Appendix XII in back of Appendix XI, Part 3, Chapter 4 of the Division of Indian Health Manual.
Add Appendix XII to Table of Contents.
Distribution: P-ABCDG under d and B, C under d
Date: October 17, 1967