Get Census Nhamcs-100(ed) 2006-2025

The Census NHAMCS-100(ED) form is a vital document for gathering data on emergency department visits. This guide provides a comprehensive, step-by-step approach to help users complete the form online with clarity and confidence.

Follow the steps to successfully fill out the NHAMCS-100(ED) form online.

1. Press the ‘Get Form’ button to access the form and open it in your preferred editing tool.
2. Begin by entering the patient information. Fill in the patient's name, date of visit (month, day), date of birth (month, day, year), and ZIP code accurately.
3. Record the time of arrival and mode of arrival. Choose from options like ambulance or personal transportation.
4. For ethnicity and race, indicate the appropriate selections using check marks as necessary, ensuring multiple options can be selected.
5. Proceed to the triage section. Enter initial vital signs, including temperature, heart rate, and blood pressure.
6. Document if the patient has received previous care or been discharged from any hospital recently, including the presenting level of pain.
7. In the reason for visit section, capture the patient's complaints or symptoms in their own words, noting the most significant issues first.
8. Indicate if the visit was related to an injury or poisoning and describe the cause, using clear, specific details.
9. List the provider's diagnoses for the visit with the primary diagnosis noted first.
10. Mark any diagnostic or screening services ordered, as well as procedures performed during the visit.
11. Record any medications or immunizations given during the visit, including both prescribed and over-the-counter options.
12. For hospital admissions, if applicable, fill out admission details, including dates and status upon discharge.
13. Once all fields are completed, review the form for accuracy and completeness before saving your changes.
14. Finally, choose to download, print, or share the completed form as necessary.

Complete your Census NHAMCS-100(ED) form online today for efficient documentation.