We use cookies to improve security, personalize the user experience, enhance our marketing activities (including cooperating with our marketing partners) and for other business use.
Click "here" to read our Cookie Policy. By clicking "Accept" you agree to the use of cookies. Read less
Read more
Accept
Loading
Form preview
  • US Legal Forms
  • Form Library
  • More Forms
  • More Multi-State Forms
  • Oh Well Child Exam Adolescence 15-20 Year 2010

Get Oh Well Child Exam Adolescence 15-20 Year 2010-2025

This screening form was adapted by the Ohio Medicaid managed care plans and Ohio Department of Job and Family Services for the. Healthchek-EPSDT .

How it works

  1. Open form

    Open form follow the instructions

  2. Easily sign form

    Easily sign the form with your finger

  3. Share form

    Send filled & signed form or save

How to fill out the OH Well Child Exam Adolescence 15-20 Year online

Completing the OH Well Child Exam for adolescents aged 15 to 20 years online is a vital step in promoting health and well-being during these formative years. This guide will provide you with clear and concise instructions to help you navigate each section of the form effectively.

Follow the steps to successfully complete the OH Well Child Exam online.

  1. Press the ‘Get Form’ button to access the OH Well Child Exam for Adolescents online and open it in your selected editor.
  2. Begin by entering the patient's name in the designated field, followed by their date of birth (DOB). Ensure that the information is accurate.
  3. Select the sex of the patient from the available options. This section may involve a dropdown menu or radio buttons.
  4. List any known allergies and current medications the patient is taking. Provide detailed information to assist in healthcare decisions.
  5. Complete the prenatal and family history of illness and disease, including any pertinent medical background that may affect the patient's health.
  6. Input the patient’s weight and the corresponding percentile rank to assess growth patterns.
  7. Enter the parent’s name in the designated area, which may be useful for follow-up communications.
  8. Document the length of the patient and the associated percentile.
  9. In the interval history section, include any relevant information regarding injuries, illnesses, or significant visits to other healthcare providers.
  10. Fill out the nutrition section by indicating daily servings of grains, fruits/vegetables, whole milk, and meat/beans. Also, specify the type of water used.
  11. Assess elimination and indicate if it is normal or abnormal.
  12. Complete the exercise assessment by noting the patient's physical activity in minutes per day.
  13. Provide details related to sleep patterns, marking whether they are normal or abnormal.
  14. For reproductive health, report on menstrual health if applicable, including any abnormalities.
  15. Address sexual activity and contraceptive methods in this section, ensuring to maintain confidentiality.
  16. Record results of screenings and procedures such as hearing, vision, dental assessments, and any noted developmental concerns.
  17. Indicate immunizations reviewed, given, and charted, along with any rationale if immunizations were needed but not administered.
  18. Document the chief complaints and general health metrics, including BMI, temperature, pulse, respiratory rate, and blood pressure.
  19. Fill in the review of systems and perform the physical exam section, marking observations as necessary.
  20. The provider should sign off the document, indicating a review of the information gathered during the exam.
  21. At the end, save the changes to your form, download the completed document for your records, or print it as needed.

Complete the OH Well Child Exam online today to ensure a thorough health evaluation for adolescents.

Get form

Experience a faster way to fill out and sign forms on the web. Access the most extensive library of templates available.
Get form

Related content

healthchek screening packet - Ohio Department of...
WELL CHILD EXAM - EARLY ADOLESCENCE: 11 - 14 YEAR (pages 47 - 49). WELL CHILD EXAM...
Learn more
Strategies for Increasing Medicaid Adolescent...
Yet well-care visit rates decline as children age into adolescence. Regular preventive...
Learn more
Behavioral Health Toolkit for Primary Care...
Follow-Up Care for Children Prescribed ADHD Medication ... The tool is a diagnostic...
Learn more

Related links form

Patrolmipdecalsalesstatemnus Form Out-of-System Public Or Nonpublic - State Of Michigan - Michigan Pathogenmiper Form Mipjunior Media Kit Print Form

Questions & Answers

Get answers to your most pressing questions about US Legal Forms API.

Contact support

The American Academy of Pediatrics recommends that children be seen at the following ages: From birth until the first birthday: Newborn, 3-5 days, 1 Month, 2 Months, 4 Months, 6 Months, 9 Months & 12 Months.

For children ages 12 to 17 (adolescent), use CPT code 99384. For children age 18 (adolescent), use CPT code 99385. For established patients making a well baby/well child care visits: • For infants under age 1, use CPT code 99391.

The most important components of a preventive well-child visit include the following: (1) developmental/behavioral assessment; (2) physical examination, including measurement of growth; (3) screening tests and procedures; and (4) anticipatory guidance.

The health screening for children may include the following: Head to toe physical examination. Developmental Screening. Vision screening. Hearing screening. Blood pressure screening.

Call the healthcare provider in these cases: Repeated temperature of 104°F (40°C) or higher in a child of any age. Fever of 100.4° (38°C) or higher in baby younger than 3 months. Fever that lasts more than 24 hours in a child under age 2. Fever that lasts for 3 days in a child age 2 or older.

To check your child's body, the doctor or nurse will: Measure your child's height and weight. Check your child's blood pressure. Check your child's vision and hearing. Check your child's body parts (this is called a physical exam) Give your child shots they need.

A child has a well-child visit EPSDT (99381 – 99461), with a well child diagnosis code (Z-code) in the first position; the sick visit code (99211 – 99215) with the modifier 25 and with the illness diagnosis CPT code in the second position.

This will include listening to the heart and lungs, checking the back for any curvature of the spine, and checking for the signs of puberty. A parent, caregiver, or chaperone should be present during this part of the exam. Siblings should stay in the waiting room to give your child privacy.

Get This Form Now!

Use professional pre-built templates to fill in and sign documents online faster. Get access to thousands of forms.
Get form
If you believe that this page should be taken down, please follow our DMCA take down processhere.

Industry-leading security and compliance

US Legal Forms protects your data by complying with industry-specific security standards.
  • In businnes since 1997
    25+ years providing professional legal documents.
  • Accredited business
    Guarantees that a business meets BBB accreditation standards in the US and Canada.
  • Secured by Braintree
    Validated Level 1 PCI DSS compliant payment gateway that accepts most major credit and debit card brands from across the globe.
Get OH Well Child Exam Adolescence 15-20 Year
Get form
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232