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Get General Instructions for DHS 8016

Division’s website, www.med-quest.us, and in the Hawaii State Medicaid Provider Manual. This form is designed to be used by providers to enter immunization(s), screening(s), and/or referral(s) that was/were attempted or not done on during a previous comprehensive EPSDT screening visit and/or not entered onto the EPSDT DHS form 8015. In addition, the EPSDT DHS 8016 form MUST be used to document any immunization or screening not captured on the EPSDT DHS 8015 form, or not associated with a comp.

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