FORMS
THIS FORM IS A DEVELOPMENTAL SCREENING COMPLETED BY THE PARENT. THIS SHOWS THE PROVIDER THE DEVELOPMENTAL PROGRESS OF CHILDREN IN COMMUNICATION, GROSS MOTOR SKILLS, FINE MOTOR SKILLS, PROBLEM SOLVING AND PERSONAL-SOCIAL SKILLS. THIS FORM IS GIVEN AT 2, 4, 6, 9, 12, 15, 18, 24, 36, 48 AND 60 MONTHS
WHAT IS AGES AND STAGES QUESTIONNAIRE? AKA ASQ.
IF A PATIENT HAS MEDICAID OR IS UNINSURED THEY ARE ELIGIBILE TO RECEIVE THIS SUPPLY FOR THEIR VACCINES
WHAT IS VFC OR STATE?
ADULT INTRAMUSCULAR.
WHAT IS 25 G 1 INCH NEEDLE?
HEIGHT/LENGTH, WEIGHT, TEMP, O2, RESPIRATIONS, PULSE
WHAT IS VITAL SIGNS FOR WCC?
THIS SCREENING STARTS AT AGE 4. YOU PLACE THE HEADPHONES ON THE PATIENT. RED GOES ON RIGHT, BLUE GOES ON LEFT. YOU GO THROUGH THE DIFFERENT DECIBLES WHILE INSTRUCTING THE PATIENT THE RAISE THE HAND OF THE SIDE THAT THEY HEAR THE NOISE IN.
WHAT IS A HEARING SCREENING?
THIS FORM LOOKS A CHILDS BEHAVIOR. IT SCREENS FOR AUSTISM CONCERNS AND IS GIVEN AT AGES 18 MONTHS AND 2 YEARS
WHAT IS THE MCHAT? (MODIFIED CHECKLIST FOR AUTISM IN TODDLERS)
THIS IS A FORM THAT IS GIVEN TO THE PARENT/GUARDIAN PRIOR TO GIVING VACCINES TO THE CHILD. IT INFORMS THEM OF THE COMPONENTS OF THE VACCINE AND ANY SIDE EFFECTS THAT MAY OCCUR.
WHAT IS VACCINE INFORMATION SHEET? OR VIS SHEET.
WHAT IS 25 G 5/8 INCH NEEDLE?
THIS IS SOMETHING YOU OBTAIN ON A BABY STARTING AT BIRTH THROUGH 3 YEARS OF AGE.
WHAT IS HEAD CIRCUMFERENCE?
BLOOD SCREENING THAT IS PERFORMED AT 12 AND 24 MONTHS
WHAT IS LEAD AND HEMOGLOBIN?
THIS FORMS HELPS THE PROVIDER DIAGNOSE ADHD IN CHILDREN. THERE IS A PARENT FORM AND ALSO A FORM FOR THE TEACHERS. IT IS ONLY GIVEN IF THERE IS A CONCERN FOR ADHD AND TYPICALLY BETWEEN THE AGES OF 6 AND 12. THIS CAN ALSO BE PROVIDER DRIVEN.
WHAT IS THE VANDERBILT ASSESSMENT SCALE?
THIS IS A WEAKENED FORM OF THE VIRUS, THAT CAN REPLICATE AND GROW, BUT DOES NOT CAUSE ILLNESS
WHAT IS LIVE VACCINES?
PEDIATRIC INTRAMUSCULAR.
WHAT IS 25 G 1 INCH OR 5/8 INCH DEPENDING ON AGE.
THIS IS A VITAL SIGN THAT STARTS AT AGE 3
WHAT IS BLOOD PRESSURE?
This is a blood test that is done once between 9-11 years of age.
What is lipids?
THIS IS A STANDARDIZED RISK SCREENING TOOL DEVELOPED TO SUPPORT PROFESSIONALS IN ADDRESSING THE RISK BEHAVIORS IN THE WELL-BEING OF YOUNG ADULTS. THERE ARE 2 DIFFERENT FORMS, ONE FOR 9-11 YEARS AND ONE FOR 12 AND UP.
WHAT IS THE RAAPS FORM?
THE RIGHT PATIENT, RIGHT VACCINE (AND DILUENT), RIGHT TIME, RIGHT DOSAGE, RIGHT ROUTE, NEEDLE AND TECHNIQUE, RIGHT SITE, RIGHT DOCUMENTATION (CONSENT)
WHAT ARE THE 7 RIGHTS TO VACCINE ADMINISTRATION?
VASTUS LATERALIS
WHAT IS THE AREA YOU GIVE VACCINES AT ON A BABY?
NEWBORN/WEIGHT CHECK, 2 WEEK, 2 MONTH, 4 MONTH, 6 MONTH, 9 MONTH, 12 MONTH, 15/18 MONTH, 24 MONTH, THEN ANNUALLY.
WHAT IS THE AGES FOR WELL CHILD CHECKS?
This is a screening that starts at the age of 3. This is performed by pointing a hand held device at the patient's eyes.
What is a vision screening?
THIS FORM CAN HELP PROVIDERS FIND MENTAL HEALTH DISORDERS IN CHILDREN.
WHAT IS THE PSC-17?
PROQUAD, VAXELIS, PENTACEL.
WHAT ARE COMBINATION VACCINES? PROQUAD-MMR/VARICELLA. VAXELIS-DTAP, HEP B, HIB AND POLIO. PENTACEL-DTAP, HIB AND POLIO.
ADULT AND PEDIATRIC INTRADERMAL INJECTION.
WHAT IS 27G 1/2 INCH NEEDLE?
THESE ARE RESULTS THAT ARE NECESSARY FOR THE NEWBORN VISIT
WHAT IS THE PKU?
This is a part of care that starts at the 2 month age.
What are vaccines?