Get Child Np Packet - Denver Urology

This guide provides clear and supportive instructions for completing the Child NP Packet required by Denver Urology. By following these steps, you can ensure that all necessary information is collected accurately and completely.

Follow the steps to effectively complete the Child NP Packet.

1. Click ‘Get Form’ button to access the Child NP Packet and open it for filling out.
2. Begin by entering the child's information in the required fields, including name, nickname, age, and date of birth, along with the address, home phone, and cell phone.
3. Provide the names of the child's parents or guardians and their contact information for emergency purposes.
4. Fill in the referring doctor's name and primary care doctor's details as requested in the required fields.
5. Select the child's ethnicity and preferred language from the provided options to ensure proper documentation.
6. Detail the reasons for the visit, specifying any urologic problems the child may have.
7. Indicate the child's height and weight, and answer the past medical history questions by circling 'yes' or 'no' as applicable.
8. List any past surgeries the child has undergone along with approximate dates in the designated section.
9. Document any allergies the child has, including specific medications that may cause allergic reactions.
10. Fill out the current medications section, listing any medications the child is currently taking or indicate if the child is not on any medications.
11. Complete the social history questions, noting participation in school or social activities and tobacco use if applicable.
12. Provide the family history details as required, including any known birth defects or abnormalities.
13. Answer the review of systems questions by marking 'yes' or 'no', and elaborate on any 'yes' responses in the space provided.
14. Sign and date the HIPAA notice acknowledgment and financial service agreement, ensuring comprehension of privacy practices.
15. If applicable, provide consent for Urology Associates to contact listed individuals regarding the child's care.
16. Once all sections are filled, you can save changes, download the completed form, print a copy, or share it as needed.

Complete the Child NP Packet online today for efficient processing of your child's medical needs.