Get Preventive Health Screening

Filling out the Preventive Health Screening form online is an essential step in ensuring that individuals receive the necessary evaluations for their health. This guide provides clear and comprehensive instructions for each section of the form, helping users navigate the process with ease and confidence.

Follow the steps to successfully complete the Preventive Health Screening form online.

1. Click ‘Get Form’ button to begin the process and access the Preventive Health Screening form in your browser.
2. Enter the patient's name in the designated field at the top of the form.
3. Locate the section labeled 'Check the appropriate box' and review the screenings performed. Mark if they were normal or abnormal.
4. For any abnormal screenings, circle the corresponding box and include a reference to the chart documentation.
5. In the physician's initials section, ensure that this is completed appropriately, especially if a referral was given.
6. Fill out the date of the screening in the provided space to maintain accurate records.
7. Indicate the age of the patient by selecting the appropriate age group from 11 to 21 years.
8. Complete the type of examination section, indicating whether it is an initial or interval examination.
9. Provide necessary measurements, including height and weight, and record blood pressure measurements.
10. Document the Body Mass Index (BMI) in the respective fields.
11. Complete the sensory screening sections for vision and hearing, marking as appropriate.
12. Fill in the developmental/behavioral assessment section based on the findings from the evaluation.
13. If applicable, conduct the unclothed physical examination and note findings.
14. Complete the procedures for routine screenings such as immunizations, hematocrit, or hemoglobin tests, and urinalysis as required.
15. If the patient is at risk, complete the corresponding screenings including lead, tuberculin, cholesterol, and STD screenings.
16. Finally, review the anticipatory guidance section and add any necessary notes on counseling topics.
17. Once all sections are completed and verified, you can choose to save the changes, download, print, or share the form as needed.

Complete your Preventive Health Screening form online today for a healthier future.