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Initial Health Assessment - Ohio Department Mental Health and ... 2026

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  1. Click ‘Get Form’ to open the Initial Health Assessment in the editor.
  2. Begin by entering the Resident’s Name, Age, Facility Name, Date, and Sex in the designated fields. Ensure accuracy as this information is crucial for identification.
  3. In the Health History section, fill out Physical details such as Height, Weight, Lungs condition, Blood Pressure (BP), Temperature (Temp), and Heart condition. This data helps health professionals assess the resident's physical state.
  4. List all current Medications along with their Route and Frequency. Include any Allergies and Dietary Requirements to ensure proper care.
  5. Check all required Personal Care Services like Bathing or Dressing. This section allows caregivers to understand the level of assistance needed.
  6. Complete the Mantoux Test section by providing dates for administration and reading results. Indicate if results are negative or positive.
  7. Finally, ensure that a Physician signs at the end of the form along with their printed name and contact information for verification.

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initial mental health assessment form

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