59 MDW Form 176 Screening Questionnaire Newborn-3 Month Visit

59 MDW Form 176 Screening Questionnaire Newborn-3 Month Visit

What Is 59 MDW Form 176?

This is a legal form that was released by the U.S. Air Force - 59th Medical Wing on February 2, 2017 and used country-wide. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is the purpose of the MDW Form 176 Screening Questionnaire Newborn-3 Month Visit?
A: The purpose of the form is to screen newborns and infants up to 3 months old during their visit.

Q: What does the screening questionnaire entail?
A: The screening questionnaire includes a series of questions to assess the health and development of the newborn or infant.

Q: Who should fill out the MDW Form 176?
A: The healthcare provider or medical staff will fill out the form during the newborn or 3-month visit.

Q: What information is collected in the questionnaire?
A: The questionnaire collects information about the baby's growth, feeding habits, sleeping patterns, and general well-being.

Q: Why is this screening important?
A: This screening helps healthcare providers identify any potential health issues or developmental delays in newborns and infants.

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Form Details:

  • Released on February 2, 2017;
  • The latest available edition released by the U.S. Air Force - 59th Medical Wing;
  • Easy to use and ready to print;
  • Yours to fill out and keep for your records;
  • Compatible with most PDF-viewing applications;

Download a fillable version of 59 MDW Form 176 by clicking the link below or browse more documents and templates provided by the U.S. Air Force - 59th Medical Wing.

Download 59 MDW Form 176 Screening Questionnaire Newborn-3 Month Visit

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