Medicare Benefits Schedule (Mbs) Healthy Kids Check Page 2
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4PATIENT HISTORY
Family and environmental factors:
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Family relationships
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Care arrangements
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Medical and social history:
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Paediatrician
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Previous presentations
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Lifestyle risk factors:
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Eating Habits
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Physical activity/inactivity
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PATIENT’S OVERALL HEALTH STATUS
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HEALTH ISSUES IDENTIFIED AND DISCUSSED WITH THE PATIENT’S PARENT/GUARDIAN
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RECOMMENDED INTERVENTION AND/OR REFERRALS
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GP, practice nurse or Aboriginal and Torres Strait
Signature:
Islander health practitioner:
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If the check has not been conducted at the
patient’s usual medical practice, a copy of the
record is to be sent to:
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Name of ‘usual’GP/Practice
Parent/Guardian consent to provide copy
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