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Montana Department of Public Health and Human Services Feeding Assistant Curriculum Evaluation Form FEEDING TECHNIQUES/ASSISTANCE W/ FEEDING COVERED (yes or no) : Basic food groups (Food Guide Pyramid)
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How to fill out feeding eval form
How to fill out a feeding eval form:
01
Begin by providing your personal information, such as your name, contact details, and any relevant identification numbers.
02
Specify the purpose of the feeding eval form. Is it for a child, an adult, or a specific medical condition?
03
Provide a detailed description of the person's current feeding habits and any difficulties they may be experiencing.
04
Include information about any underlying medical or psychological conditions that may affect the person's feeding abilities.
05
Document any allergies or dietary restrictions the person may have.
06
Describe the person's food preferences and aversions, if applicable.
07
Detail any current feeding interventions or strategies being used, such as feeding tubes or specialized utensils.
08
Discuss the person's mealtime behaviors, such as willingness to try new foods or any issues with chewing or swallowing.
09
Include any relevant medical test results or consultations with other healthcare professionals related to the person's feeding issues.
10
Finally, sign and date the form to acknowledge that the provided information is accurate and complete.
Who needs a feeding eval form:
01
Infants or children who are experiencing feeding difficulties, such as difficulty latching onto a bottle or breastfeeding, food aversions, or prolonged feeding times.
02
Individuals with medical conditions that impact their ability to eat or digest food properly, such as gastrointestinal disorders, swallowing difficulties, or food allergies.
03
Adults or elderly individuals who may require specialized feeding interventions or modifications due to physical or cognitive impairments.
04
People undergoing medical treatments that may affect their ability to eat, such as chemotherapy or surgeries.
05
Individuals with developmental or behavioral disorders that may impact their feeding abilities, such as autism spectrum disorder or sensory processing disorder.
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What is feeding eval form?
The feeding eval form is a document used to evaluate an individual's feeding habits and nutrition intake.
Who is required to file feeding eval form?
Healthcare professionals, nutritionists or caregivers may be required to fill out the feeding eval form for individuals who need dietary assessment.
How to fill out feeding eval form?
The feeding eval form can be filled out by providing information about the individual's eating habits, food preferences, allergies, and any dietary restrictions.
What is the purpose of feeding eval form?
The purpose of the feeding eval form is to assess and track an individual's nutritional intake, identify any dietary deficiencies or issues, and develop a suitable diet plan.
What information must be reported on feeding eval form?
Information such as food intake frequency, portion sizes, meal schedules, any medication interactions, and special dietary needs must be reported on the feeding eval form.
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