PATIENT HISTORY AND PHYSICAL for ADULT DAY HEALTH CARE COMMUNITY BASED 2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the patient's name and date of birth at the top of the form. Ensure accuracy as this information is crucial for identification.
3. In the DIAGNOSES / CONDITIONS section, select the primary diagnosis from the provided options. If necessary, attach any electronic health records (EHR) that reflect the patient's health status.
4. Complete the PHYSICAL EXAMINATION section by filling in relevant comments and vital signs such as temperature, pulse, and blood pressure.
5. For MEDICATION PROFILE, list all medications along with their dosage, route, and frequency. This ensures comprehensive medication management.
6. Fill out any additional sections like STANDING ORDERS and DIET ORDERS based on patient needs and preferences.
7. Finally, ensure that all required signatures are obtained before submitting the form for processing.

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