Get History & Physical (h&p) Form Mi Via, Nm Self-directed Medicaid ...

Completing the History & Physical (H&P) Form for the Mi Via, NM Self-Directed Medicaid Waiver Program can seem overwhelming. This guide provides step-by-step instructions to help you seamlessly fill out the form online.

Follow the steps to efficiently complete your H&P form.

1. Press the ‘Get Form’ button to access the document and open it in a suitable editor.
2. Enter today's date in the designated space. This helps to ensure the form is current.
3. Provide the patient's name clearly in the specified field, followed by their date of birth.
4. Fill in the vital signs section, noting the pulse, respiratory rate, height, weight, temperature, and blood pressure in the appropriate fields.
5. Document any diagnoses along with their corresponding ICD-9 codes, ensuring accuracy for medical records.
6. List all current medications, including over-the-counter drugs and supplements known to the patient.
7. Provide a brief medical history, focusing especially on any disabilities, both physical and cognitive.
8. Complete the general/constitutional review and any findings related to the skin, breasts, eyes, ears, nose, mouth, and throat.
9. Continue filling in the cardiovascular, respiratory, gastrointestinal, genitourinary, musculoskeletal, neurologic, psychiatric, allergic, immunologic, lymphatic and endocrine sections, detailing any relevant findings.
10. Add any follow-up comments or instructions that may be necessary.
11. The form must be signed by an authorized health provider such as an MD, DO, CNP, or PAC in the signature section.
12. Record the date of the provider's signature and the office telephone number in the allocated spaces.
13. Once all fields are completed, save the document. You can also download, print, or share the completed form via email.

Complete your documents online today for a smoother process.