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Extended Care Information 20162017 CCAS Extended Care Program is available after school to provide a safe, loving environment for students in K3 through 5th grade. Students must be picked up by 6:00

How to fill out extended care information sheet

How to fill out an extended care information sheet:

1. Start by gathering all the necessary information. This includes personal details such as the individual's full name, date of birth, and contact information. Additionally, you may need to provide details about any existing medical conditions or allergies.
2. Begin filling out the extended care information sheet by entering the emergency contact details. Make sure to include the names, phone numbers, and relationships of at least two emergency contacts who can be reached in case of an emergency.
3. Next, provide information about the individual's primary healthcare provider. This should include the doctor's name, clinic or hospital name, contact information, and any relevant medical insurance details.
4. It is important to provide a complete medical history. Include any previous or ongoing medical conditions, surgeries, hospitalizations, and medications that the individual is currently taking. Make sure to mention any allergies or adverse reactions to certain medications.
5. If the individual has any specific dietary needs or restrictions, ensure that these are clearly outlined on the extended care information sheet. This can include preferences, allergies, or any dietary restrictions due to religious or cultural reasons.
6. Mention any additional important information that the caregiver or extended care staff should be aware of. This can include behavioral or emotional considerations, communication preferences, mobility issues, or specific instructions for administering medications or treatments.

Who needs an extended care information sheet?

1. Individuals who are enrolled in an extended care program or facility, such as a nursing home, assisted living facility, or rehabilitation center, may be required to fill out an extended care information sheet. This is to ensure that the staff has access to all the necessary information required for providing appropriate care.
2. Individuals who regularly receive home care services or have a caregiver visiting their residence may also be asked to fill out an extended care information sheet. This helps the caregiver to be well-informed about the individual's medical history, preferences, and any special requirements.
3. It is beneficial for individuals with chronic health conditions, disabilities, or elderly individuals who may require additional medical attention or support to have an extended care information sheet. This ensures that in case of an emergency or when seeking healthcare services, relevant information is readily available to healthcare professionals.

For pdfFiller’s FAQs

What is extended care information sheet?

Extended care information sheet is a document that provides detailed information about a patient's medical history, current treatments, and care plan.

Who is required to file extended care information sheet?

Healthcare providers, such as doctors and hospitals, are required to file extended care information sheet for patients receiving ongoing care.

How to fill out extended care information sheet?

Extended care information sheet can be filled out by documenting the patient's medical history, current medications, treatment plans, and any other relevant information.

What is the purpose of extended care information sheet?

The purpose of extended care information sheet is to ensure that healthcare providers have access to accurate and up-to-date information about a patient's care in order to provide the best possible treatment.

What information must be reported on extended care information sheet?

The extended care information sheet must include the patient's medical history, current medications, treatment plans, and any allergies or other relevant health information.

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