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By signing this form, you confirm the patient has been diagnosed with one or more of the following severe or disabling chronic conditions.
All ICD-10-CM diagnosis codes are identified as one of the following three categories: Chronic (value 1) Examples include malignant cancer, diabetes, obesity, hypertension, and most mental health conditions.
An Annual Review is required for all patients with a chronic disease. The purpose of an annual review is to ensure patients are taking the right medication and receiving the best possible care for their condition(s).
About Chronic Diseases. Chronic diseases are defined broadly as conditions that last 1 year or more and require ongoing medical attention or limit activities of daily living or both. Chronic diseases such as heart disease, cancer, and diabetes are the leading causes of death and disability in the United States.
The Chronic Illness Verification Sample Form allows parents to excuse absences due to a specific medical condition with the same authority as a medical professional. California EC Section 48260.5. requires a notice to the parent or guardian upon a pupils classification as a truant.
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