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DATE WELL CHILD EAGERLY CHILDHOOD: 18 Months PATIENT NAME DOB SEX PARENT NAME Allergies Current Medications Prenatal/Family History Chief Complaint Weight Percentile Length Percentile % Interval History:
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Begin by opening the 18months2010 healthchek-epsdt finaldoc form on your computer or printing a hard copy.
02
Fill in the patient's personal information section, including their full name, date of birth, and contact information.
03
Provide the patient's medical history, including any pre-existing conditions, medications, and surgeries they may have had.
04
Document the patient's height, weight, and vital signs, such as blood pressure.
05
Indicate any developmental milestones the patient has reached at 18 months, such as walking, talking, or fine motor skills.
06
Record the results of the health screenings, such as hearing and vision tests.
07
Note any immunizations or vaccinations the patient has received and update the immunization record accordingly.
08
Include any necessary notes or comments regarding the patient's overall health and well-being.
09
Sign and date the form, ensuring that all required fields have been completed accurately.
10
Finally, submit the filled out form according to the appropriate guidelines or return it to the designated healthcare provider.
The 18months2010 healthchek-epsdt finaldoc is needed for individuals who are 18 months old and have undergone health check-up or EPSDT (Early and Periodic Screening, Diagnosis, and Treatment) services. This form helps healthcare providers document and evaluate the patient's health status, developmental milestones, and other relevant information for the purpose of monitoring their growth, addressing any potential health concerns, and providing appropriate care. It serves as a valuable tool for both healthcare professionals and the patients' caretakers in ensuring comprehensive healthcare for young children.
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It is a form used to document a child's health check-up and EPSDT screening at 18 months in 2010.
Healthcare providers and caregivers of children who are 18 months old in 2010.
The form should be filled out with the child's health information, screening results, and signed by the healthcare provider.
The purpose is to ensure that children receive necessary health check-ups and screenings to detect any developmental or health issues early on.
Information such as the child's vitals, growth measurements, developmental milestones, screening results, and any recommendations for follow-up care.
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