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GeorgiaDepartmentofPublicHealthREFUGEEDOMESTICHEALTHASSESSMENTFORM/INVOICE
ToBeCompletedByHealthProviders
PAGE1OF2
COUNTY:ALIEN#:DATEOFHEALTHASSESSMENT:
MM SEX:PATIENT\'S NAME:CITY:ZIP:I94STATUS:COUNTRYOFBIRTH:SPONSOR(Choose):Refugee
Immigrant
AsyleePORTOFENTRY:INTERPRETATIONPROVIDED
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How to fill out refugee domestic health assessment

How to fill out refugee domestic health assessment
01
Obtain the necessary form for the refugee domestic health assessment.
02
Gather all required personal information for the refugee, including their name, age, gender, and contact information.
03
Schedule an appointment with a healthcare provider who is experienced in conducting refugee domestic health assessments.
04
Bring the refugee to the appointment and ensure they are prepared to answer any medical history questions.
05
Work with the healthcare provider to fill out the form accurately, including any medical conditions or medications the refugee may have.
06
Review the completed form with the refugee to ensure all information is correct and make any necessary adjustments.
07
Submit the form to the appropriate agency or organization for further processing.
Who needs refugee domestic health assessment?
01
Refugees who have recently arrived in a new country and are in need of a health assessment to ensure they receive proper medical care and support.
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What is refugee domestic health assessment?
Refugee domestic health assessment is a comprehensive medical evaluation conducted on refugees upon their arrival or resettlement in a new country to ensure their health needs are addressed.
Who is required to file refugee domestic health assessment?
Healthcare providers or organizations responsible for the care of refugees are required to file refugee domestic health assessment.
How to fill out refugee domestic health assessment?
Refugee domestic health assessment forms can be filled out by healthcare professionals based on the medical history and examination findings of the refugee.
What is the purpose of refugee domestic health assessment?
The purpose of refugee domestic health assessment is to identify and address any health conditions or concerns of refugees to promote their overall well-being.
What information must be reported on refugee domestic health assessment?
Information such as medical history, current health status, vaccination records, and any existing health conditions must be reported on refugee domestic health assessment.
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