Health Screening and Assessment
Health History and Screening of an Adolescent or Young Adult Client
Save this form on your computer as a Microsoft Word document. You can expand or shrink each area as you need to include the relevant data for your client. Submit this resource with your assignment to the instructor by the end of Module 3.
|Student Name: Oluwaseun Obajolu |Date:08/16/2012 |
|Biographical Data |
|Patient/Client Initials :A.A |Phone No:6469320857 |
|Address:1105 Farley drive, Randallstown, MD |
|Birth Date:05/03/1995 |Age:17 |Sex: Male |
|Birthplace: Lagos, Nigeria |Marital Status: Single |
|Race/Ethnic Origin: African |
|Occupation: Student |Employer: N/A |
|Financial Status: |
| |
|Client is a full time student who currently gets health insurance under his mother’s health insurance coverage |
|Source and Reliability of Informant: Self and Mother.
Save this form on your computer as a Microsoft Word document. You can expand or shrink each area as you need to include the relevant data for your client. Submit this resource with your assignment to the instructor by the end of Module 3.
|Student Name: Oluwaseun Obajolu |Date:08/16/2012 |
|Biographical Data |
|Patient/Client Initials :A.A |Phone No:6469320857 |
|Address:1105 Farley drive, Randallstown, MD |
|Birth Date:05/03/1995 |Age:17 |Sex: Male |
|Birthplace: Lagos, Nigeria |Marital Status: Single |
|Race/Ethnic Origin: African |
|Occupation: Student |Employer: N/A |
|Financial Status: |
| |
|Client is a full time student who currently gets health insurance under his mother’s health insurance coverage |
|Source and Reliability of Informant: Self and Mother.