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PEDIATRIC CARDIAC RISK ASSESSMENT FORM NAME: D.O.B. I. PATIENT HISTORY QUESTIONS: Tell me about any of these in your child Yes No Yes No Has your child fainted or passed out DURING exercise, emotion.

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How to fill out the Cardiac Assessment Format Pdf online

Filling out the Cardiac Assessment Format Pdf is a crucial step in assessing a child’s cardiac health. This guide will provide clear, step-by-step instructions to help users complete the form effectively and accurately.

Follow the steps to fill out the form correctly.

  1. Click ‘Get Form’ button to obtain the form and open it in the editor.
  2. Begin by filling in the child's name and date of birth at the top of the form. Ensure that the information entered is correct and legible.
  3. Proceed to section I, which addresses patient history questions. For each question, indicate 'Yes' or 'No' based on the child's medical history. Take your time to consider each question carefully.
  4. Move to section II, which inquires about family history. Again, answer each question with 'Yes' or 'No'. If you answer 'Yes' to any question, you will have an opportunity to provide additional explanations in the designated area.
  5. After answering all questions, ensure you have completed the parent/guardian signature section. Include the date of signing.
  6. Finally, make sure to have the provider's signature and the corresponding date. Review all entries for accuracy. Once completed, you can save changes, download, print, or share the form.

Start filling out the Cardiac Assessment Format Pdf online today.

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