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4234 N Freeway Blvd., Ste 500, Sacramento, CA 95834, Phone: 9166483999 Fax: 9166481919 HISTORY AND PHYSICAL FOR ADULT DAY HEALTH CARE / COMMUNITY BASED ADULT SERVICES Patient Name: DOB: Phone Number:.

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This guide provides detailed instructions on completing the Altamedix document online. Whether you are assisting someone or filling it out for your own use, these steps will help you navigate the process smoothly.

Follow the steps to fill out the Altamedix form effectively.

  1. Utilize the ‘Get Form’ button to access the Altamedix form and open it in the online editor.
  2. Enter the patient name in the designated field. Ensure that the name is recorded accurately as this is crucial for identification.
  3. Provide the date of birth (DOB) in the specified area. Input should follow the format requested.
  4. Fill in the phone number, ensuring you include the area code for accurate contact information.
  5. Complete the address fields including street address, city, and zip code. Double-check for accuracy.
  6. Proceed to the diagnoses and conditions section. Select the primary diagnosis by checking the appropriate box.
  7. If applicable, detail additional diagnoses by selecting from the various categories provided, using the checkboxes available.
  8. In the physical examination section, fill out the required metrics including temperature, pulse, respiratory rate, height, and weight.
  9. Complete the TB screening section by entering details from the relevant assessments, including PPD results and any notable health history.
  10. If there are medications, complete the medication profile diligently, inputting each medication’s name, dosage, route, and frequency.
  11. Indicate any allergies in the appropriate section to ensure comprehensive health records.
  12. Review the standing orders section and make necessary modifications by striking through any orders that are not applicable.
  13. Finalize by completing the request for adult day health care section, ensuring all fields are thoughtfully filled and signed by the primary care provider (PCP).
  14. Once completed, you can save your changes, download, print, or share the form as required.

Get started on completing your Altamedix document online today.

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