Get Va 032-05-0007 2022-2025

Filling out the VA 032-05-0007 form is an essential step in ensuring proper documentation for resident physical examinations at assisted living facilities. This guide provides clear, step-by-step instructions to help you complete the form accurately.

Follow the steps to successfully complete the VA 032-05-0007 form.

1. Click the ‘Get Form’ button to access the VA 032-05-0007 form and open it in your preferred editing tool.
2. Begin by filling out the name of the person examined in the designated field. Make sure to include the full legal name as it appears on identification documents.
3. Next, enter the date of examination. This date must be within 30 days preceding the person’s admission to the assisted living facility.
4. Complete the address and telephone sections with the correct details of the individual being examined.
5. Record the height and weight of the person in the provided fields.
6. Enter the blood pressure information. Ensure that the reading is current and accurate.
7. Provide a summary of the significant medical history. Include any prior illnesses, surgeries, or chronic conditions.
8. Review the general physical condition section carefully and fill it out with relevant information regarding the systems review, as medically indicated.
9. Document any allergies, including food, medication, or other reactions, to ensure safety and proper care.
10. Indicate whether the person is ambulatory or nonambulatory, based on the definitions provided in the form.
11. Answer the question regarding the individual's capability of self-administering medication by selecting 'Yes' or 'No'.
12. If applicable, respond to the specific care needs or conditions the person may have, making sure to provide comments where necessary.
13. Complete the recommendations for care section, ensuring that medications, diet, therapy, and other necessary information are accurately detailed.
14. For tuberculosis screening, fill out the results of the risk assessment, ensuring it aligns with current Virginia Department of Health guidelines.
15. Finally, provide the name, signature, and contact information of the physician or designee who conducted the examination.
16. Once all sections are complete, you can save the form, download it for your records, print a copy, or share it as necessary.

Start filling out your VA 032-05-0007 form online today for a smooth and efficient process.