Health care appraisal 2026

1. Click ‘Get Form’ to open the health care appraisal in the editor.
2. Begin by entering the Licensee Name, Resident Name, AFC Facility Name, Case Number, and Facility License Number in the designated fields.
3. Fill in the Worker Name/Load Number and Worker Phone Number to ensure proper communication.
4. Review the sections for medical information release. Sign and date where indicated for both General Medical Information and HIV/AIDS Information.
5. Complete the health assessment by providing details such as Height, Weight, Blood Pressure, Age, and Sex in their respective fields.
6. Document any current medications and allergies in the specified sections to ensure comprehensive care.
7. Assess physical exam results by checking appropriate boxes for each body part examined and noting any abnormalities or treatments ordered.
8. Finally, have a qualified professional sign off on the form with their printed name, title, address, and date of signature.

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