WebThe Staying Healthy Assessment (SHA) is a Department of Health Care Services requirement consisting of questionnaires for all Medi-Cal beneficiaries as part of their … WebStaying Healthy Assessment Adult Patient’s Name (first & last) Date of Birth Female Male Today’s Date Person Completing Form (if patient needs help) Family Member Friend Other …
STAYING HEALTHY ASSESSMENT - Preferred IPA
WebPlease answer all the questions on this form as best you can. Circle “Skip” if you do not know an answer or do not wish to answer. Be sure to talk to the doctor if you have … http://www.sfhp.org/wp-content/files/providers/forms/SHA_PowerPoint.ppsx south main auto repair llc avoca new york
CHADIS Adult Questionnaires
WebState of California — Health and Human Services Agency Department of Health Care Services DHCS 7098 H (Rev 12/13) SHA (Adult) Page 1 of 2 Staying Healthy Assessment Adult Patient’s Name (first & last) Date of Birth Female Male Today’s Date Person Completing Form (if patient needs help) Family Member Friend Other (Specify) WebStaying Healthy Assessment is the DHCS’s sponsored and approved IHEBA ... due to teen health confidentiality laws and to increase the likelihood of obtaining accurate responses to sensitive questions. The PCP will determine the most appropriate age, based on discussion with the parent/guardian and the family’s ethnic/cultural background. ... WebYou and your health care team can work together towards better health. Please answer these questions as best you can. ) “Skip” if you do not know an answer or do not wish to … teaching moment definition