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Get Mi Dch-1315 2018-2025
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How to fill out the MI DCH-1315 online
This guide provides essential instructions for completing the MI DCH-1315 form online. By following the outlined steps, users can efficiently provide their health information, which will be used to enhance their care under the Healthy Michigan Plan.
Follow the steps to complete the MI DCH-1315 form.
- Click the ‘Get Form’ button to retrieve the MI DCH-1315 and open the document in your preferred online editor.
- Enter your personal information in the designated fields at the beginning of the form. This includes your first name, middle name, last name, suffix (if applicable), date of birth, mailing address, phone number, and MI Health Card number. Ensure that this information is accurate and up to date.
- Proceed to Section 1, where you will respond to initial assessment questions. For each question, select the answer that best represents your current health status or situation. Remember that not all questions require a response, and providing accurate information helps in meeting your healthcare needs.
- In Section 2, you will fill out details regarding your annual check-up appointment. Enter the date of your appointment in the provided field and specify any topics you wish to discuss with your doctor.
- Section 3 requires you to reflect on your readiness to make changes to improve your health. Answer the questions on a scale of 0 through 5, considering the support you feel you would receive from family, friends, and your healthcare provider.
- Section 4 is to be completed by your primary care provider. Ensure that they fill out the necessary parts during your appointment. This includes assessing your health behavior goals and providing their attestation.
- After your appointment, make sure to save a copy of the completed form, particularly the section signed by your primary care provider. This document serves as your record of participation in the Health Risk Assessment.
- Finally, once you have filled out all applicable sections, save your changes, download a copy, print the form, or share it as necessary. Follow any further instructions provided for submitting the completed document.
Complete your MI DCH-1315 form online today to take an active role in your health care.
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