While the actual name for it is the adult prevention and chronic care flowsheet, we’ll separate these 2 because of the differences.
However, this sheet (the adult preventative part) is basically a summary of the problems and medications that a patient is currently on. This DD Form 2766 helps providers with quick access to these facts and supports how they care for these particular patients.
How often should the DD Form 2766 be updated?
This form must be updated during every patient’s visit. It should also be reviewed annually and before transferring HREC or OREC.
What is the DD Form 2766 made of?
This DD Form 2766 is made up of 5 parts but in 4 separate pages:
- Significant health problems
- hospitalization/surgery
- Medical alert
- medications
- Health maintenance (immunizations, deployment, readiness, etc.)
DD Form 2766: Significant health problems
Only put in important or significant medical conditions. Sometimes this would include chronic diseases like hypertension (high blood pressure), diabetes, or arthritis. Also include acute recurrent illnesses like urinary tract infections (UTI), recurrent otitis media, recurrent bronchitis, etc.
DD Form 2766: Hospital/surgery
Only include significant surgical conditions. This must also include all procedures that use anesthesia and any procedures that might have long-term effects on the patient’s health status.
DD Form 2766: Medical alert
This section is for allergies as well as what happens in the reaction. It can be anything from food, a drug to latex.
You also want to add chronic illnesses which also includes alcohol and tobacco use
DD Form 2766: Medications
This is just a list of all drugs that the patient is currently or recently taking
DD Form 2766 Medical maintenance
This part must contain general medical information such as mammograms, chest X-rays, EKGs, and pap smears.
Generally, you must enter the due date in pencil that you can erase mistakes.
Here, you can also include occupational health issues like the patient’s involvement in the asbestos program, the hearing conservation program, or exposure to lead.
You can add in lab tests such as blood type, G6PD, and sickle cell trait
