Get 18-21 Years Old Ahcccs Epsdt Tracking Form - Health Net Access

Filling out the 18-21 Years Old AHCCCS EPSDT Tracking Form is essential for ensuring the health and well-being of young individuals. This guide provides clear, step-by-step instructions for successfully completing the form online.

Follow the steps to accurately complete the form online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering the individual's last name and first name at the designated fields. Make sure to provide accurate details as this information identifies the user.
3. In the primary care provider section, include the name of the primary care provider along with their phone number in the corresponding fields.
4. Document the individual’s AHCCCS ID number and health plan in the respective fields to ensure proper identification and coverage.
5. List current medications, vitamins, and herbal supplements in the designated area. Be thorough to help healthcare providers understand the user's medical background.
6. Indicate allergies by checking the appropriate boxes and specifying any known allergies in the space provided.
7. Complete the health metrics section by filling out the fields for blood pressure, weight, temperature, pulse, height, and respiratory rate. Ensure accurate measurements are recorded.
8. For the vision chart exam, audiometry, and family/social history sections, provide the relevant data as required, checking the appropriate options.
9. Fill in the anticipatory guidance provided and social-emotional health sections as observed by the clinician or reported by the individual for comprehensive evaluation.
10. Complete the comprehensive physical exam section by checking whether findings are within normal limits (WNL) or abnormal, and noting any specific details as necessary.
11. In the labs ordered section, indicate any tests that are to be performed, such as TB skin test or lipid profile.
12. Document any immunizations ordered and provide details about their administration, refusal, or deferral as required.
13. Ensure all required sections are completed and review the form for accuracy. Make any necessary corrections before finalizing.
14. Once satisfied with the form content, users can save changes, download, print, or share the completed form as needed.

Complete your documents online to ensure essential health tracking and care.