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Staying Healthy Assessment Questionnaires - DHCS

(2 days ago) WEBCurrently all questionnaires are available in a PDF format. Please note: Farsi, and Khmer age-specific SHA questionnaires are available upon request. Please contact the health plan you contract with for copies. DHCS 7098 A (12/14) - Staying Healthy Assessment: 0-6 Months. Alt: Arabic, Armenian, Chinese, Hmong, Korean, …

https://www.dhcs.ca.gov/formsandpubs/forms/Pages/StayingHealthyAssessmentQuestionnaires.aspx

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“STAYING HEALTHY” ASSESSMENT Adolescents, 12–17 years …

(2 days ago) WEB“STAYING HEALTHY” ASSESSMENT Adolescents, 12–17 years of age _____ _____ Patient Number Plan Name/Number DHS 7098 D (9/05) Health Education Behavioral Assessment Page 2 of 2 For Clinical Use Intervention Codes: C: Counseling EM: Educational Materials R: Referral F: Follow-up Needed SPN: See Progress Notes 17. …

https://pmgmd-com.nettantra-cdn.com/wp-content/uploads/2014/08/staying_healthy_assessment_-_english_12_to_17.pdf

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SH Tip 12-17 LK Revisions - Partnership HealthPlan of California

(4 days ago) WEBThese educational handouts were developed for the “Staying Healthy” assessment tool provider handbook by a group of Medi-Cal managed care health plans. Staying Healthy California Teens 12 to 17 years old American Cancer Society 1-800-ACS-2345 California Smokers Helpline 1-800-NO-BUTTS (English) 1-800-45-NO-FUME (Spanish)

http://www.partnershiphp.org/Providers/HealthServices/Documents/Health%20Education/staying-healthy-%2012-17-EN.pdf

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Staying Healthy Assessment - Riverwalk Pediatric

(4 days ago) WEBState of California — Health and Human Services Agency Department of Health Care Services DHCS 7098 G (06/13) SHA (12 – 17 Years) Page 1 of 2 Staying Healthy Assessment 12 – 17 Years Name (first & last) Male Date of Birth Female Today’s Date Grade in School: Person Completing Form

http://www.riverwalkpediatric.com/storage/app/media/EnglishFormsPdf/SHA_12-17yrs.pdf

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Staying Healthy Assessment (12-17 Years) - healthmark …

(6 days ago) WEBStaying Healthy Assessment (12-17 Years) Question # Question Text Yes No Skip 1 Do you drink or eat 3 servings of calcium rich foods daily such as formula, breastmilk, cheese, yogurt, soy milk or tofu? 2 Do you eat fruits and vegetables at least two times per day? 3 Do you eat high fat foods, such as fried

https://healthmark-group.com/wp-content/uploads/2022/02/Staying-Health-12-17-Years.pdf

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Staying Healthy Assessment - Blue Shield of California

(5 days ago) WEBState of California — Health and Human Services Agency Department of Health Care Services DHCS 7098 H (Rev 12/13) SHA (Adult) Page 1 of 2 Staying Healthy Assessment Adult Patient’s Name (first & last) Date of Birth Female Male Today’s Date Person Completing Form (if patient 17 Do you smoke or chew tobacco? No Yes Skip …

https://www.blueshieldca.com/content/dam/bsca/en/shared/documents/legacy/BSP_2019_DHCS_7098_H_ENGLISH_SHA_Adult.pdf

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Staying Healthy Assessment (SHA) Training - cencalhealth.org

(8 days ago) WEB12-17 yrs. Adult A Staying Healthy Assessment (SHA) must be completed as part of the Initial Health Assessment, or new patient exam, within 120 days of enrollment in CenCal Health. A new SHA form must also be completed whenever the patient enters a new age group. It is recommended that the form be reviewed by the PCP at annual check-

https://www.cencalhealth.org/wp-content/uploads/2021/10/2014staying-healthy-assessment-training-material.pdf

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Achieving Initial Health Assessment (IHA) & Staying Healthy …

(1 days ago) WEB•The DHCS-sponsored and approved IHEBA used is the Staying Healthy Assessment (SHA). Initial Health Assessment (IHA) overview 6 Initial Health Assessment Staying Healthy Assessment Adolescents (12-17 yrs.) •Annual re-administration is recommended for adolescents due to frequently changing behavioral risk factors for this …

https://www.blueshieldca.com/bin/cms/bsca/services/portal/provider/StreamDocumentServlet?fileName=PRV_IHA_SHA_webinar.pdf

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Staying Healthy Assessment Questionnaires (SHA) - PromiseCare

(Just Now) WEBStay Healthy Assessment FAQs (PDF) Behavioral Risk Topics At-A-Glance (PDF) Adult Questions by Age Group (PDF) Staying Healthy Assessment: 12-17 Years. English, Arabic, Armenian, Chinese, Hmong, Korean, Russian, Spanish, Tagalog, Vietnamese. Staying Healthy Assessment: 9-11 Years

https://promisecare.com/staying-healthy-assessment-questionnaires-sha/

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Staying Healthy Assessment FAQs - San Francisco Health Plan

(5 days ago) WEBStaying Healthy Assessment FAQs What is the Staying Healthy Assessment (SHA)? The SHA is the Department of Health Care Services’ (DHCS) 0-6 months, 7-12 months, 1-2 years, 3-4 years, 5-8 years, 9-11 years, 12-17 years Adult (18-55 years) and Senior (55+, at provider’s discretion) 2. Filling out the SHA:

https://www.sfhp.org/wp-content/files/providers/forms/Self_Health_Assessment_FAQs.pdf

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Staying Healthy - DHCS

(3 days ago) WEBStaying Healthy Assessment Senior Patient’s Name (first & last) Date of Birth Female 17 Do you brush and floss your teeth daily? Yes No Skip No Yes Skip Department of Health Care Services DHCS 7098 I (Rev 12/13) SHA (Senior) Page 1 of 2. State of California —Health and Human Services Agency Department of Health Care Services …

https://www.dhcs.ca.gov/formsandpubs/forms/Forms/DHCS_7098_I_ENGLISH_SHA_Senior.pdf

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State of California Health and Human Services Agency …

(5 days ago) WEBState of California — Health and Human Services Agency Department of Health Care Services DHCS 7098 H (Rev 12/13) SHA (Adult) Page 1 of 2 Staying Healthy Assessment Adult Patient’s Name (first & last) Date of Birth Female Male Today’s Date Person Completing Form (if patient needs help) Family Member Friend Other (Specify)

https://www.olehealth.org/wp-content/uploads/2022/05/StayingHealthyAssessment_Adult_English.pdf

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Staying Healthy Assessment 12-17 years - Pacific Coast Pediatrics

(8 days ago) WEBA pediatric wellness coach meets with children and teens for fun and engaging lessons about healthy eating and physical activity. The goal is to create lifelong healthy habits to share with the whole family, based on a 5-2-1-0 message: 5 or more fruits and vegetables a day; 2 hours or less of “screen time” 1 hour or more of physical activity

https://pacificcoastpediatrics.com/patient-forms/staying-healthy-assessment-12-17-years/

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DHCS - Staying Healthy Assessment (SHA) Provider Training

(5 days ago) WEBIn 2013, DHCS released the new DHCS sponsored IHEBA forms called Staying Healthy Assessment. We will talk about other types of health education behavioral assessment forms later. The SHA also helps to prevent duplication of this information by providing a standardized form. DHCS requires Medi-Cal providers to administer the SHA or other

https://www.cahealthwellness.com/content/dam/centene/cahealthwellness/pdfs/DHCS-SHA-Provider-Training.pdf

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Staying Healthy Assessment FAQs - Partnership HealthPlan of …

(5 days ago) WEBexpected to complete Staying Healthy Assessments (SHA) for all Members by the April 1, 2014 deadline. By April 1, providers needed to be trained and prepared to administer the SHA per MMCD PL 13-001 as follows: For new Members: the SHA and Initial Health Assessment (IHA) must be administered/completed within 120 days of enrollment.

http://www.partnershiphp.org/Providers/HealthServices/Documents/Health%20Education/SHA_FAQs.pdf

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Staying Healthy Assessment

(8 days ago) WEBStaying Healthy Assessment 12 – 17 Years DHCS 7098 G (Rev 12/14) SHA (12 – 17 Years) Page 1 of 2 Name (first & last) Date of Birth Female Male Today’s Date Grade in School: Staying Healthy Assessment Ages 12-17 Years Keywords: SHA,healthy,assessment,DHCS,"managed care"

https://www.olehealth.org/wp-content/uploads/2022/05/StayingHealthyAssessment_12-17yrs_English.pdf

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Staying Healthy - San Francisco Health Plan

(5 days ago) WEBDHCS 7098 G (Rev 12/14) SHA (12 – 17 Years) Page 1 of 2 Staying Healthy Assessment 12 – 17 Years. Name (first & last) Date of Birth Female Male Today’s Date Grade in School: Person Completing Form Parent Relative Friend Guardian Other (Specify) Staying Healthy Author:

https://www.sfhp.org/wp-content/files/providers/forms/SHA_12-17%20Years%20English.pdf

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Provider Update: Staying healthy assessment

(4 days ago) WEBStaying Healthy Assessment . The Department of Health Care Services (DHCS) requires primary care physicians (PCPs) to complete the Staying Healthy Assessment (SHA), DHCS’s approved Individual Health Education Behavioral Assessment (IHEBA) for Health Net Community Solutions, 12 - 17 Yrs : √; √: √: Adult : √

https://providerlibrary.healthnetcalifornia.com/content/dam/centene/healthnet/pdfs/providerlibrary/2018updates/18-519_CMC_SHA%20Provider%20Update.Instruction%20Sheet.Stitched.FINAL.pdf

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Staying Healthy Assessment - Blue Shield of California

(6 days ago) WEBState of California — Health and Human Services Agency Department of Health Care Services DHCS 7098 I (Rev 12/13) SHA (Senior) Page 1 of 2 Staying Healthy Assessment Senior Patient’s Name (first & last) Date of Birth Female Male Today’s Date Person Completing Form (if patient 17 Do you brush and floss your teeth daily? Yes …

https://www.blueshieldca.com/content/dam/bsca/en/shared/documents/legacy/BSP_2019_DHCS_7098_I_ENGLISH_SHA_Senior.pdf

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Staying Healthy Assessment

(6 days ago) WEBState of California — Health and Human Services Agency Department of Health Care Services DHCS 7098 G (06/13) SHA (12 – 17 Years) Page 1 of 2 Staying Healthy Assessment 12 – 17 Years Name (first & last) Date of Birth Female Male Today’s Date Grade in School: Person Completing Form Parent Relative Friend Guardian

https://www.prempediatrics.com/wp-content/uploads/SHA-English-12-17Years.pdf

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