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Get Hawaii Follow Up 2010-2024

Ropriate for the areas covered by today s visit The DHS 8016 form should be used to document the completion of any screening(s) and/or immunization(s) that were attempted and not done during a comprehensive EPSDT Screening visit (8015 document). In addition, the 8016 must be used to document any immunization or screening not captured on the 8015, or not associated with a comprehensive EPSDT screening visit. PATIENT INFORMATION Screen Date (MMDDYY) Name (Last, First, Middle Initial) Medic.

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