Get Health Status Questionnaire Form

The Health Status Questionnaire Form is crucial for gathering comprehensive health information about a person aged 15 to 18 years. This guide provides clear and step-by-step instructions on how to complete the form online effectively.

Follow the steps to fill out the Health Status Questionnaire Form online

1. Press the ‘Get Form’ button to access the Health Status Questionnaire Form and open it in your designated online editor.
2. Begin by filling in personal information, including the name and date of birth of the individual, and indicate who they live with. Options may include mother, father, or other caregivers.
3. Select the type of school attended by the individual (public, private, chartered, or home school) and indicate their current grade (9th through college).
4. Rate the individual's academic performance using the options provided (excellent, good, fair, poor, failing) and indicate if there has been a history of suspension with a simple yes or no.
5. Outline the individual's future career goals, selecting from options such as college, work, military, or associate degree.
6. Detail lifestyle habits, including daily caffeine use, body image perception, dental hygiene practices, tobacco use, and safety measures like seat belt and helmet use.
7. Complete the Tuberculosis (Tb) Screen Questions, noting any relevant vaccination history or exposure to Tb within the household or high-risk countries.
8. Document eating habits and activity levels, distinguishing between regular meals, snacks, and exercise routines.
9. Discuss voiding habits and bowel patterns, as well as sleep quality and any temperament concerns.
10. Complete the Review of Systems section by indicating any symptoms related to various bodily systems, using yes or no options.
11. If applicable, record any allergy concerns or previous serious vaccine reactions.
12. Address any additional concerns about the individual's health or specific conditions, such as asthma, using the indicated questions.
13. After completing all sections, review the entire form for accuracy. Finally, save changes, and choose to download, print, or share the completed form as needed.

Complete the Health Status Questionnaire Form online to ensure accurate health information is recorded.