Resident Demographics
Patient Number	Age (Years)	Gender (F/M)	Weight (kg)	Current Feeding Regimen (e.g. Ensure 6 scoops x 6 feedings per day, water flushes not required)	Full (F) or Supplemental (S) Feeding	Estimated Length of Time on Tube Feeding	Resident in Home Since Month/Year (e.g.Aug/ 2018)	Feeding Mode (NG/ NJ/ PEG/ FJ)
						A = < 1 month
						B = 1 to < 3 months
						C = 3 to < 6 months
						D = 6 to < 12 months
						E = 12 to < 36months (3 years)
						F = > 36 months (3 years)
						G = Unsure
E.g.	80	F/M	55	Ensure 7 scoops x 2 feedings	S	D	Jun 2016	NG/ NJ/ PEG/ FJ
1		F/M						NG/ NJ/ PEG/ FJ
2		F/M						NG/ NJ/ PEG/ FJ
3		F/M						NG/ NJ/ PEG/ FJ
4		F/M						NG/ NJ/ PEG/ FJ
5		F/M						NG/ NJ/ PEG/ FJ
6		F/M						NG/ NJ/ PEG/ FJ
7		F/M						NG/ NJ/ PEG/ FJ
8		F/M						NG/ NJ/ PEG/ FJ
9		F/M						NG/ NJ/ PEG/ FJ
10		F/M						NG/ NJ/ PEG/ FJ
11		F/M						NG/ NJ/ PEG/ FJ
12		F/M						NG/ NJ/ PEG/ FJ
13		F/M						NG/ NJ/ PEG/ FJ
14		F/M						NG/ NJ/ PEG/ FJ
15		F/M						NG/ NJ/ PEG/ FJ