Get Correctional Screening Forms

Filling out the Correctional Screening Forms online is a crucial process for individuals seeking evaluation for hepatitis C treatment. This guide aims to provide clear and detailed instructions for users on how to complete the form effectively and accurately.

Follow the steps to complete your Correctional Screening Forms online

1. Press the 'Get Form' button to access the Correctional Screening Forms. Once clicked, the form will open in your online editor, ready for completion.
2. Begin by entering the date and time at the top of the form. Ensure that these details are accurate to ensure proper documentation.
3. Provide the patient's age and the Effective Prison Release Date (EPRD) in the designated fields. This information is vital for the screening process.
4. List any allergies in the specified section. Users should be thorough to avoid potential adverse reactions during treatment.
5. Review the past medical history criteria. Answer the questions regarding past health issues and mark 'Yes' or 'No' as applicable. Make sure to provide any additional details if necessary, as this can affect treatment eligibility.
6. Proceed to the section on mental health history. Answer the questions regarding feelings of depression or interest in activities honestly, to ensure appropriate mental health referrals if needed.
7. Complete the immunization history by listing the dates for completed vaccinations. If certain vaccinations have not been done, ensure to order them as indicated.
8. Fill in the baseline physical exam results. Record vital signs and general physical condition as required in the specified fields.
9. Document the baseline test results, including dates and outcomes for tests such as Hep C genotype and other relevant lab results.
10. In the assessment and plan section, specify the HCV genotype and treatment status. Be honest about any patient ineligibilities or reason for refusal of treatment.
11. Finalize the form by signing and entering the clinician's name and date of completion in the designated sections. Ensure all information is accurate and complete before submission.
12. After completing the form, you can save changes, download a copy, print it, or share it as necessary.

Start filling out your Correctional Screening Forms online today to ensure a seamless evaluation process.