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AWV PERSONALIZED ACTION PLAN Guide to Action Plan for Spe - wehealny

AWV PERSONALIZED ACTION PLAN Guide to Action Plan for Spe - wehealny 2026

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The document is an Annual Wellness Visit (AWV) form designed to assess a patient's health risks and create a personalized action plan. It includes sections for risk assessment across various domains such as activities of daily living, behavior, cognition, and preventive screenings. The form outlines specific actions based on the patient's responses, including referrals to specialists, recommendations for lifestyle changes, and necessary screenings or vaccinations.

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Click ‘Get Form’ to open it in the editor.
Begin by entering the Patient’s Name and Date of Birth at the top of the form. This information is essential for identifying the patient.
Proceed to the RISK ASSESSMENT section. Carefully review each domain, marking 'YES' or 'NO' based on the patient's responses regarding their health risks.
In the PREVENTIVE SCREENING section, indicate any necessary screenings by checking the appropriate boxes. This helps ensure that all preventive measures are addressed.
Complete the ACTION PLAN section by following recommendations based on previous answers. Make sure to note any referrals or appointments needed for further care.

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