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2016 KIDS OUT ENRICHMENT PROGRAM
HEALTH HISTORY FORM
SANFORDSPRINGVALE YMCAChilds Last Name:First Name:MEDICAL HISTORY
Does your child have any chronic or recurring Illness? Please explain. Does your
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Step 1: Gather all the necessary information and documents required for filling out the form.
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Step 3: Assess the severity of the situation or condition based on the provided criteria.
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Step 4: Fill out the form by selecting the appropriate severity level for each point or aspect.
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Step 5: Provide additional details or explanations, if required, to support your assessment.
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The severity assessment form helps in understanding and categorizing the level of severity, which can be useful for decision-making, prioritization, and resource allocation.
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What is if any how severe?
If any how severe refers to the level of impact or seriousness of a particular situation or event.
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The purpose of if any how severe is to assess and understand the severity of a particular situation or event.
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Information related to the impact, severity, and consequences of the situation or event must be reported on if any how severe.
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