Cardiac assessment checklist pdf 2026

1. Click ‘Get Form’ to open the cardiac assessment checklist in the editor.
2. Begin by entering the patient's name and date of birth at the top of the form. This information is crucial for identifying the patient.
3. Proceed to Section I, 'Patient History Questions.' For each question, select 'Yes' or 'No' based on your child's experiences during exercise. Ensure you answer all questions accurately.
4. Next, move to Section II, 'Family History Questions.' Similar to the previous section, indicate 'Yes' or 'No' for each question regarding family history. This information helps assess potential hereditary risks.
5. If you answered 'Yes' to any questions, provide additional details in the space provided at the end of Section II. This context can be vital for healthcare providers.
6. Finally, ensure that both parent/guardian and provider signatures are completed along with dates before submitting the form.

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