Immunizations # Question Response Action Purpose Main Panel 4a. Can we look over <baby’s name>’s shot record buttons: If yes, then enable 4b. Rapport, Process today? Yes, No 4b. DTaP immunization record viewed today and shots Radio buttons: If yes, then enable 4c. Immunization data have been given? Yes, No collection, Referral 4c. Text box, 99, Numeric Compute adequacy Immunization data ___# of DTaP immunizations based on age and collection, Referral number of DTaP. Display referral message if not up to date. Bottom Panel Information, 1st DTaP is at 2 months of age Referral 2nd DTaP is at 4 months of age 3rd DTaP is at 6 months of age 4th DTaP is between 15 and 18 months of age Oral Health # Question Response Action Purpose Main Panel 5a. What questions do you have regarding caring for Text box Contents of text box go Risk 381, Referral <baby’s name>’s gums and teeth? to S portion of care plan. 381 - Dental problems Bottom Panel Visual observation if needed. Referral if needed.
Immunizations # Question Response Action Purpose Main Panel 4a. Can we look over <baby’s name>’s shot record today? buttons: Yes, No If yes, then enable 4b. Rapport, Process 4b. DTaP immunization record viewed today and shots have been given? Radio buttons: Yes, No If yes, then enable 4c. Immunization data collection, Referral 4c. Text box, 99, Numeric ___# of DTaP immunizations Compute adequacy based on age and number of DTaP. Display referral message if not up to date. Immunization data collection, Referral Bottom Panel 1st DTaP is at 2 months of age 2nd DTaP is at 4 months of age 3rd DTaP is at 6 months of age 4th DTaP is between 15 and 18 months of age Information, Referral Oral Health # Question Response Action Purpose Main Panel 5a. What questions do you have regarding caring for <baby’s name>’s gums and teeth? 381 - Dental problems Text box Contents of text box go to S portion of care plan. Risk 381, Referral Bottom Panel Visual observation if needed. Referral if needed.