Readiness Essentials™: Wesley Blanco Health History

800 Country Club Road, P.O. Box 2540, Waterbury, CT 06723 | 1.800.749.2427 | SentinelU.com 1

Client: Wesley Blanco Table of Contents

Client Information ……………………………………………………………………………………………………………………. 2

Health History …………………………………………………………………………………………………………………………. 3

New Patient Self-Rated Wellbeing Checklist ……………………………………………………………………………….. 4

Readiness Essentials™: Wesley Blanco Health History

800 Country Club Road, P.O. Box 2540, Waterbury, CT 06723 | 1.800.749.2427 | SentinelU.com 2

Client Information Client Information

Name Age Wesley Blanco 13 years old Race/Ethnicity Language(s) Filipino, White English Sex Assigned at Birth Gender Identity Pronouns Male Non-Binary They/Them Height Weight Marital Status 4’ 11” / 150 cm 88 lb / 40 kg Single Allergies NKA Chief Complaint Guilt, Anxiety

Readiness Essentials™: Wesley Blanco Health History

800 Country Club Road, P.O. Box 2540, Waterbury, CT 06723 | 1.800.749.2427 | SentinelU.com 3

Health History Health History

Past Visit Reasons None Past Medical History None Past Surgical History None Family History Tourette’s syndrome (Father) Systemic lupus erythematosus (Mother) Immunizations Hepatitis B (3-dose series) (18 months old) Measles, mumps, rubella (2-dose series) (5 years

old) Rotavirus RV1 (2-dose series) (4 months old) Varicella (2-dose series) (5 years old) Diptheria, tetanus, & acellular pertussis (5-dose series) (5 years old)

Haemophilus influenzae type b (3-dose series) (12 months old)

Tetanus, diptheria, & acellular pertussis (12 years old)

Inactivated poliovirus (4-dose series) (5 years old)

Pneumococcal conjugate (4-dose series) (15 months old)

Meningococcal (1st of 2 dose series) (12 years old)

Social History Smoking Status: None Smokeless Tobacco: None Alcohol Use: None Drug Use: None Current Diet: Standard American/Filipino Heritage How Often do you Exercise: 5x/week Type Exercise: School PE Wears Seatbelt: Yes Sexually Active: No How Many Sexual Partners: 0 How Many Partners in Lifespan: 0 How Long with Current Partner: N/A Contraception: N/A History of STIs: None Feels Safe at Home: Yes Health Maintenance Last Annual Exam: 6 months ago Vision Problems: No Wears Contacts or Glasses: No Last Eye Exam: 6 months ago Dentist Every Six Months: Yes Brushes/Flosses Daily: Yes Has Trouble Hearing: No Social Determinants of Health Financial Resource Strain: Denies Transportation Needs: Denies Housing Instability: Denies Food Insecurity: Denies

Healthcare.gov Preventative – Health Services

U.S. Department of Health and Human Services – Health Screening

The United States Preventive Services Taskforce

CDC Immunization Schedules

Readiness Essentials™: Wesley Blanco Health History

800 Country Club Road, P.O. Box 2540, Waterbury, CT 06723 | 1.800.749.2427 | SentinelU.com 4

New Patient Self-Rated Wellbeing Checklist New Patient Self Rated Well Being Checklist

Please rate the following items that best describe your experiences over the last 2 weeks. Statement None of

the Time Rarely Some of

the Time Often All of the

Times I feel physically energized and healthy.

X

I engage in regular physical activity or exercise.

X

I can manage stress effectively. X I have a positive outlook on life. X I feel emotionally stable and content. X I have a positive outlook on life. X I feel a sense of purpose and fulfillment in my daily activities.

X

I have a strong support system of family and friends.

X

I have a balanced and nutritious diet. X

Our website has a team of professional writers who can help you write any of your homework. They will write your papers from scratch. We also have a team of editors just to make sure all papers are of HIGH QUALITY & PLAGIARISM FREE. To make an Order you only need to click Ask A Question and we will direct you to our Order Page at WriteDemy. Then fill Our Order Form with all your assignment instructions. Select your deadline and pay for your paper. You will get it few hours before your set deadline.