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SENTARA HEALTH PLANS CLINICAL PRACTICE GUIDELINE:WELL CHILD FORMS Early Periodic Screening, Diagnosis, and Treatment (EPSDT) FormsGuideline History Date Approved 03/07 Date Revised Date Reviewed Next
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How to fill out well child forms
How to fill out well child forms
01
Gather the child's personal information, including name, date of birth, and insurance details.
02
List any current medications or treatments the child is undergoing.
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Note the child's medical history, including past illnesses, surgeries, and allergies.
04
Include developmental milestones that the child has achieved.
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Provide information about the child's family medical history.
06
Fill out any specific questions related to the child's nutrition and lifestyle.
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Ensure all sections are completed accurately and sign the form where required.
Who needs well child forms?
01
Parents or guardians of children under the age of 18.
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Healthcare providers conducting routine check-ups for children.
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Schools or childcare facilities requiring health documentation.
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Insurance companies needing health information for coverage.
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What is well child forms?
Well child forms are documents used to record the health and development of children during routine check-ups and preventive care visits.
Who is required to file well child forms?
Parents or guardians are required to file well child forms for their children, typically during visits to healthcare providers for routine check-ups.
How to fill out well child forms?
To fill out well child forms, the parent or guardian should provide accurate information regarding the child's health history, developmental milestones, vaccinations, and any current health concerns during the visit.
What is the purpose of well child forms?
The purpose of well child forms is to ensure that children receive appropriate preventive care, monitor their growth and development, and identify any potential health issues early.
What information must be reported on well child forms?
Information that must be reported on well child forms includes the child's medical history, present health status, immunization records, developmental milestones, and any behavioral concerns.
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