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How to fill out the Stroke Registry Form - Unified Health Management Information online
This guide provides comprehensive instructions on completing the Stroke Registry Form for users seeking to report important health information online. By following these steps, you will ensure that your submission is accurate and complete.
Follow the steps to successfully fill out the Stroke Registry Form online.
- Press the ‘Get Form’ button to access the Stroke Registry Form and open it in your preferred online editor.
- Fill in the general data section by entering the name of the reporting health facility, hospital patient ID, and other required fields such as the hospital registry number and hospital case number.
- Provide the patient's personal information including their last name, first name, middle name, sex, civil status, and mother’s maiden name.
- Enter both the permanent and temporary addresses of the patient, ensuring that the region, province, city/municipality, barangay, and zip code are accurately filled.
- Add the patient's contact details including the landline number, mobile number, and email address.
- Complete the section for the date of birth, place of birth, religion, nationality, race, ethnicity, highest educational attainment, occupation, and company.
- Document smoking habits, physical activity details, usual diet intake, and any history of alcohol use as required by the form.
- Detail any family history of diseases and the specific diseases/attacks as instructed in the related section.
- Provide stroke data including the referral source, dates of consultation and diagnosis, type of stroke, and presenting symptoms.
- Specify the treatment administered and the final diagnosis, including the ICD-10 code and patient status.
- If applicable, enter details regarding death, including the underlying cause, date of death, place of death, and disposition.
- Complete the contact details for the consultant in charge and the person completing the form, including their address, landline, mobile number, and email address.
- Once you have completed all sections, review your entries for accuracy. Then, save your changes, download, print, or share the form as needed.
Take action now by completing the Stroke Registry Form online to contribute to the essential health data collection.
Risk factors for stroke. High blood pressure. Obesity. Physical inactivity. Poor diet. Smoking.
Fill Stroke Registry Form - Unified Health Management Information ...
The Get With The GuidelinesStroke program is a quality improvement initiative designed to enhance adherence to evidencebased stroke care. The American Heart Association's Get With The Guidelines ® Stroke registry is an online, interactive assessment and reporting system. Considerable variation exists in the delivery of acute stroke care and stroke outcomes across settings and population groups. RES-Q Registry uses one harmonized data collection form, both for primary as well as comprehensive stroke centres. Form is simple and uses dynamic fields. A large component of all our Standard Sets, therefore, is the collection of patientreported outcomes. Recommended Citation: Division of Public and Behavioral Health, Chronic Disease Prevention and Health Promotion, Heart Disease and Stroke. Prevention. 2.23 Health Liaison. Where was the patient when stroke was detected or when symptoms were discovered (15)?. 1=Not in a health care setting.
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