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20162017 Pediatric and Adolescent Influenza Screening Questionnaires This printed material contains sensitive PIN protected under the Privacy Act which is FOR OFFICIAL USE ONLY and must be protected

How to fill out 2016-2017 pediatric and adolescent

The 2016-2017 pediatric and adolescent form is typically filled out by healthcare providers or medical professionals who are treating pediatric patients between the ages of 0-18 years. The form captures essential information about the patient's medical history, current health status, and any relevant developmental milestones. Here is a step-by-step guide to filling out the form:

1. Begin by writing the patient's personal information, including their name, date of birth, gender, and contact details. This information helps to identify the patient accurately and maintain their medical records.
2. Next, document the patient's medical history, including any known allergies, chronic conditions, previous surgeries, or hospitalizations. This information is crucial in providing appropriate and safe care to the patient.
3. Record the patient's family medical history. This section helps identify any genetic or hereditary diseases that may be relevant to the patient's current or future health. Include details about parents, siblings, and other close relatives.
4. Document the patient's current medications, including prescription drugs, over-the-counter medications, and any dietary supplements. This section ensures that healthcare providers are aware of any potential drug interactions or contraindications.
5. Record the patient's immunization history. Include dates of all vaccinations received, including those for diseases like measles, mumps, rubella, polio, hepatitis, etc. This information helps assess the patient's vaccination status and determine if any additional immunizations are required.
6. Include information about the patient's growth and development. Record their height, weight, head circumference (in infants), and any notable milestones achieved at different ages. This helps assess the patient's physical and cognitive development.
7. Document the patient's social history, including their living situation, family dynamics, educational status, and any behavioral or emotional concerns. This information provides insights into the patient's overall well-being and can help guide appropriate interventions if necessary.
8. Finally, ensure all sections of the form are complete and accurate. Review the information provided before submitting the form to minimize errors or missing data. Update the form as necessary during subsequent visits.

Remember, the 2016-2017 pediatric and adolescent form is designed to gather comprehensive information about a young patient's health. It aids in diagnosis, treatment planning, and monitoring their overall well-being. Family physicians, pediatricians, and other medical professionals who provide care to children and adolescents typically utilize this form.

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What is pediatric and adolescent influenza?

Pediatric and adolescent influenza refers to the flu virus that affects children and teenagers.

Who is required to file pediatric and adolescent influenza?

Healthcare providers and facilities are required to file pediatric and adolescent influenza cases.

How to fill out pediatric and adolescent influenza?

Providers can fill out pediatric and adolescent influenza reports online through the designated reporting system.

What is the purpose of pediatric and adolescent influenza?

The purpose of pediatric and adolescent influenza reporting is to track and monitor the spread of the flu among children and teenagers.

What information must be reported on pediatric and adolescent influenza?

Information such as age, gender, symptoms, and test results must be reported on pediatric and adolescent influenza cases.