http://www.partnershiphp.org/Providers/HealthServices/Pages/SHA-Training-for-Providers.aspx http://www.sfhp.org/wp-content/files/providers/forms/DHCS%207098%20I%20ENGLISH_SHA_Senior%2012.13_Writable.pdf

Form DHCS7098 C Download Printable PDF or Fill …

WebState of California —Health and Human Services Agency Department of Health Care Services Staying Healthy Assessment Adult Patient’s Name (first & last) Date of Birth … WebState of California — Health and Human Services Agency Department of Health Care Services DHCS 7098 B (Rev 12/14) SHA (7 – 12 Months) Page 1 of 2 Staying Healthy … chiptuning radolfzell

Patient Forms - NH Health Center

WebStaying Healthy Assessment . Senior . Patient’s Name (first & last) Date of Birth Female Male Today’s Date Person Completing Form (if patient needs help) ... State of California — Health and Human Services Agency Department of Health Care Services . Clinic Use Only . Counseled Referred Anticipatory Guidance Follow-up Ordered Comments ... WebDepartment of Health Care Services). 2. Any alternative assessments must be translated into Spanish and Chinese and meet all the same standards as the SHA. 3. The American Academy of Pediatrics’ Bright Futures assessment has been pre-approved by DHCS as an alternative IHEBA. It can be used as long as it is the most current version. 4. 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 … chiptuning range rover velar