DCH-1315-Healthy Michigan Assessment-FINAL-PLAN COPY 4 28 14docx-2026

1. Click ‘Get Form’ to open the DCH-1315 document in the editor.
2. Begin by filling out your personal information in the designated fields, including your name, date of birth, and contact details.
3. Proceed to Section 1, where you will answer initial assessment questions. Check one option for each question regarding your health and lifestyle habits.
4. In Section 2, provide details about your annual appointment. Specify the month you scheduled it and any topics you wish to discuss with your doctor.
5. Move to Section 3 and select one or more healthy behaviors you are interested in changing over the next year. Rate your readiness for change using the provided scale.
6. Leave Section 4 blank for your primary care provider to complete during your appointment. Ensure they sign and date this section after filling it out.
7. Once completed, save a copy of the form for your records. You can print it directly from our platform or download it as needed.

Start editing your DCH-1315 form today for free and take a step towards better health!