Get Child Physical Examination Please Print All Information - Info Dhhs State Nc

Filling out the child physical examination form is essential for documenting a child's health status and ensuring proper care. This guide provides clear, step-by-step instructions to assist you in completing the form accurately and efficiently online.

Follow the steps to fill out the child physical examination form online

1. Press the ‘Get Form’ button to acquire the form and open it in your online editor.
2. Begin by entering the child's name, date of birth, sex, and race/ethnicity in the designated fields. Ensure all information is printed clearly.
3. Fill in the county Department of Social Services (DSS) and the name of the social worker overseeing the case.
4. Provide the name of the person accompanying the child to the appointment.
5. Enter the name and contact information of the examining physician, including their address and telephone number.
6. Document the physical examination findings, including temperature, pulse, respirations, blood pressure, height (percentile), weight (percentile), and head circumference (percentile).
7. Complete the screening information for vision and hearing, marking the appropriate choices and indicating if the child wears glasses.
8. Select the developmental screening conducted and detail the results, offering comments if necessary.
9. Record any pertinent lab results if required, including hemoglobin/hematocrit and TB skin test.
10. Indicate the physical exam findings, marking each item as normal or abnormal as applicable.
11. List any medical or dental conditions needing attention or any communicable diseases tested.
12. Answer whether the child displays any signs or symptoms of communicable diseases that pose transmission risks in a household.
13. Provide recommendations including additional tests, follow-up treatment, medications, immunizations, limitations on physical activity, or any other relevant notes.
14. Have the examining physician sign and date the form to validate the examination.
15. Once all fields are completed, review the form for accuracy, then save changes, download, print, or share the form as needed.

Complete your child physical examination form online to ensure your child's health needs are met.