Get Dhhs 2801 Problem Need List - Nc Division Of Public Health

The DHHS 2801 Problem Need List is a vital document used by the North Carolina Division of Public Health to compile important health-related information. This user-friendly guide will help you navigate the process of filling out the form online, ensuring that all necessary information is correctly reported.

Follow the steps to complete the DHHS 2801 Problem Need List online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering the last name, first name, and middle initial of the individual in the designated fields. Ensure that the information is accurately captured to avoid any discrepancies.
3. Input the patient number using the assigned identifier, which is crucial for tracking purposes.
4. Fill in the date of birth in the specified format (MM-DD-YYYY), ensuring accuracy to maintain health records.
5. Select the race by checking the appropriate box. Options include White, Black/African American, American Indian/Alaska Native, Asian, Native Hawaiian/Other Pacific Islander, and Other.
6. Indicate the ethnicity regarding Hispanic/Latino origin by selecting 'Yes' or 'No' as per the individual’s status.
7. Specify the individual’s gender by checking the corresponding box for Male or Female.
8. Provide the county of residence to help with regional health tracking.
9. Record the date of onset or diagnosis of any chronic issues. Include ICD-9 codes and resolution dates for tracking ongoing health concerns.
10. Follow the same format for acute problems, documenting the date of onset or diagnosis, ICD-9 codes, and resolution dates.
11. Include any relevant history or surgeries in the provided space, recording dates and descriptions as necessary.
12. Once all information is entered, review the form carefully for any errors or missing data.
13. When satisfied with the completed form, save any changes, and choose to download, print, or share the document as needed.

Complete the DHHS 2801 Problem Need List online today to ensure accurate health information documentation.