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*25009* 25009UR Number:*Family name:ACT HealthDiabetes Vision Screen and Foot Assessment Referral Forgiven names: DOB:Gender:Patient Details Given names: Family name: Date of birth: Address:Contact
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To fill out the diabetes vision screen, follow these steps:
02
Gather the necessary information, including the patient's personal and medical details.
03
Begin by recording the patient's demographics, such as their name, age, and contact information.
04
Move on to documenting the patient's medical history, specifically focusing on any diabetes-related issues or complications.
05
Conduct a vision screening by performing visual acuity tests and examining the patient's eyes.
06
Record the results of the vision screening, including any abnormalities or concerns.
07
Provide recommendations or referrals based on the screening results, if necessary.
08
Conclude the form by signing and dating it to authenticate the document.
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Ensure the completed diabetes vision screen is properly filed and stored according to the established protocol.

Who needs diabetes vision screen and?

01
Diabetes vision screen is necessary for individuals who have diabetes or are at risk of developing diabetes.
02
It is recommended for individuals with type 1 or type 2 diabetes, as well as those with prediabetes.
03
Regular vision screenings are also important for individuals who have a family history of diabetes or diabetic eye conditions.
04
Additionally, individuals with existing diabetes-related eye problems or symptoms should undergo regular vision screening.
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Diabetes vision screen is a screening test to monitor and assess the vision of individuals with diabetes.
Individuals with diabetes are required to undergo diabetes vision screen at regular intervals as advised by healthcare professionals.
To fill out diabetes vision screen, individuals need to visit an eye specialist or healthcare provider for a comprehensive eye examination.
The purpose of diabetes vision screen is to detect any vision problems early and prevent further complications related to diabetes.
Information such as visual acuity, intraocular pressure, retinal examination, and other eye tests results must be reported on diabetes vision screen.
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