MI DHS-1637 2015-2025 free printable template

WELL CHILD EXAM ADOLESCENCE: 15 18 YearAuthority: P.A. 116 of 1973 Completion: Required Consequences of noncompletion: Noncompliance of licensing rules.Michigan Department of Health and Human Services Well

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How to fill out MI DHS-1637

1. Start by downloading the MI DHS-1637 form from the Michigan Department of Health and Human Services website.
2. Fill out the applicant's name, address, and contact information at the top of the form.
3. Provide the date of the application and any relevant identification numbers, if applicable.
4. Complete the sections regarding income and employment history, including sources and amounts of income.
5. Fill in details about household members and their relation to the applicant.
6. Include any relevant information related to medical or financial assistance being requested.
7. Review all entries carefully for accuracy and completeness.
8. Sign and date the form at the designated area.
9. Submit the completed form according to the instructions, either via mail or in person.

Who needs MI DHS-1637?

1. Individuals or families seeking assistance from the Michigan Department of Health and Human Services.
2. Those who require medical support, financial aid, or other forms of aid managed by MI DHS.
3. Applicants aiming to enroll in various assistance programs offered by the state.

People Also Ask about

How do you describe a general physical exam?

A thorough physical examination covers head to toe and usually lasts about 30 minutes. It measures important vital signs -- temperature, blood pressure, and heart rate -- and evaluates your body using observation, palpitation, percussion, and auscultation.

How do you write a normal physical exam?

PHYSICAL EXAMINATION - Normal. Vital signs: BP 120/80; P 68/min reg; RR 14/min; T 36.9 °C; Wt. General: Well-developed, well-nourished, appearing stated age. Head: Normocephalic without scalp lesions. Neck: Neck supple with full range of motion (ROM). Chest & back: No abnormal curvature of spine. Lungs: Cardiovascular:

What elements should be documented for a well child visit?

Initial Health History The initial/basic health history must be found in the clinical record, and all components documented including: medical history, family history, prenatal and birth history, social history, review of systems and immunization status.

What is included in a child's physical exam?

Along with checking your child's vital signs and monitoring their height and weight your pediatrician will also check hearing, eyesight, respiration, cardiac activity and reflexes. A physical exam will check all systems of your child's body to make sure that everything is functioning properly.

How do you document a normal ear exam?

Ears – The pinna, tragus, and ear canal are non-tender and without swelling. The ear canal is clear without discharge. The tympanic membrane is normal in appearance with a good cone of light. Hearing is intact with good acuity to whispered voice.

How do you conduct a physical exam for a child?

The infant or child's face should be symmetrical; observe for nutritional status, hygiene, mental alertness, and body posture and movements; examine the skin for color, lesions, bruises, scars, and birthmarks; observe hair texture, thickness, and distribution. Noting psychological status and behavior.

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What is MI DHS-1637?

MI DHS-1637 is a form used by the Michigan Department of Health and Human Services that is required for individuals or households seeking certain assistance programs.

Who is required to file MI DHS-1637?

Individuals or households applying for public assistance programs in Michigan, such as food assistance or cash assistance, are required to file MI DHS-1637.

How to fill out MI DHS-1637?

To fill out MI DHS-1637, applicants need to provide personal information, income details, household composition, and other relevant data as required by the form. It is essential to follow the provided instructions carefully.

What is the purpose of MI DHS-1637?

The purpose of MI DHS-1637 is to collect necessary information from applicants in order to determine their eligibility for various assistance programs offered by the Michigan Department of Health and Human Services.

What information must be reported on MI DHS-1637?

Information that must be reported on MI DHS-1637 includes personal identification, household size, income sources, expenses, and any other relevant details that may affect eligibility for assistance programs.