CareLink - Vendor

To register a client, review our guide here: Client Registration

1 CNA - Questionnaires and Surveys
2 Member Info
- 2.1 Background
- 2.2 Height and Weight
- 2.3 Exam Dates
- 2.4 Care Team
- 2.5 Demographics
- 2.6 General Health
- 2.7 Diagnosis
- 2.8 Disaster Plan
- 2.9 Home Life
- 2.10 Current Providers
- 2.11 Resources
- 2.12 Service Plan
3 Health & Well-Being
- 3.1 Health Behaviours
- 3.2 Caregiver
- 3.3 ADL / IADL
- 3.4 Sleep
- 3.5 Employment
- 3.6 D.M.E.
- 3.7 Legal
- 3.8 Safety/Injuries
- 3.9 Future Plans
- 3.10 Financial Support
4 Clinical Summary
5 Tasks
6 Flags
7 Services
- 7.1 To add a Service:
- 7.2 To delete a Service:
- 7.3 To View Service Graph:
8 Client Tracking Items
- 8.1 Active Clients
- 8.2 Deactivated Clients
9 Project Tracking Items
- 9.1 Data Uploads:
- 9.2 Reports
- 9.3 Correct Failed Xerox Uploads
- 9.4 Opt Status Updates
10 Questions

CNA - Questionnaires and Surveys

Tip: For each questionnaire and/or survey, click Save to submit answers or Cancel to return to the Assessments tab.

Tip: Within each questionnaire and/or survey, validation will occur after clicking ‘Save’. If any errors exist, an orange indicator will appear next to the question. Hover over the orange indicator to view the recommendation text.

From the Client Dashboard:

Click the CNA tab.
Provider Location drop-down list is displayed at the top of the page. Users will be able to select any location they have access to. If users only have access to one location, the drop-down list will not be displayed.
Navigation buttons for Member Info, Health & Well-Being, and Clinical Summary questionnaires are displayed underneath the Provider Location drop-down list.
Historical data for Clinical Screen, C-SSRS, Anxiety, Depression, Audit-10, and PC-PTSD Surveys are displayed towards the bottom of the page.

Member Info

Background

Click the Background button in the Member Info section.
Type in a response for ‘What brought you in for services today?’
Select Yes or No for ‘Would you like an interpreter?’
Select Yes or No for ‘Do you have a developmental/intellectual disability?’
1. If Yes, select Yes or No for ‘Do you have an Individual Service Plan related to your developmental/intellectual disability?
Select Yes or No for ‘Do you have an Emergency Crisis Plan? (If yes, please provide a copy)’
Select Yes or No for ‘Were you referred?’
1. If Yes, select Yes or No ‘If yes, by whom were you referred?’
Type in a response for Nursing Facility Level of Care (NFLOC).
Click Save.

Height and Weight

Click the Height & Weight button in the Member Info section.
Type in a response for Height (in inches).
Type in a response for Weight (in pounds).
After the Height and Weight are entered, BMI is automatically calculated.
Click Save.

Exam Dates

Click the Exam Dates button in the Member Info section.
Select a date from the calendar picker for the Date of the last physical exam or select ‘Don’t Know’.
Select a date from the calendar picker for the Date of the last dental exam or select ‘Don’t Know’.
Select a date from the calendar picker for the Date of the last vision exam or select ‘Don’t Know’.
Select a date from the calendar picker for the Date of the last hearing exam or select ‘Don’t Know’.
Select a date from the calendar picker for the Date of the last bone density exam or select ‘Don’t Know’.
Click Save.

Care Team

Click the Care Team button in the Member Info section.
Select a Care Coordinator from the Name drop-down list.
1. This list is populated from the Profile Staff list in Vendor Registration. Contact your Vendor Admin if a name does not appear in this list.
Type in a Name for Primary Care Provider.
Type in a Phone Number for Primary Care Provider.
Type in a Name for Behavioral Health Therapist.
Type in a Phone Number for Behavioral Health Therapist.
Type in a Phone Number for Behavioral Health Therapist.
Type in data for up to 4 additional care team members.
Click Save.

Demographics

Click the Demographics button in the Member Info section.
Type in a response for the Name of the person filling out the assessment.
Select a response for the Relationship of the person filling out the assessment to the person coming in today from the drop-down list.
1. If ‘Other’ is selected from the drop-down list, type in a response.
Select Yes or No for ‘Are there cultural or religious preferences that you would like your provider to be aware of today?’
1. If Yes is selected, type in a descriptive response.
Click Save.

General Health

Click the General Health button in the Member Info section.
Select Yes or No for ‘Are you currently in any physical pain?’
1. If Yes, indicate how much the pain is by selecting a response from the 0-10 scale.
2. If Yes, type in a response for ‘Where is your pain?’
Select Yes or No for ‘Have you ever had a traumatic brain injury (head injury, concussion)?’
Select Yes or No for ‘Do you need help with transportation to appointments?’
Select a response from the Excellent-Poor scale for general, physical health. Select ‘Prefer not to answer’ if appropriate.
Select a response from the Excellent-Poor scale for general, mental health. Select ‘Prefer not to answer’ if appropriate.
Select Yes or No for ‘Have you had any psychiatric hospitalization in the last 6 months?’. Select ‘Prefer not to answer’ if appropriate.
Select Yes or No for ‘Are you currently taking atypical psychotropic medications, such as Ability, Clozaril, Zyprexa, Seroquel, Risperdal, or Geodon?’. Select ‘Prefer not to answer’ if appropriate.
Select a response from the Not bothered at all – Bothered a lot scale for ‘How much are you bothered by medication side effects (for example, shaking and trembling, not being able to think clearly, gaining or losing weight, or sexual problems)?’. Select ‘Prefer not to answer’ if appropriate.
Click Save.

Diagnosis

Click the Diagnosis button in the Member Info section.
Type in a response for Diagnosis.
Click Save.

Disaster Plan

Click the Disaster Plan button in the Member Info section.
Type in a response for Disaster Preparedness Plan.
Click Save.

Home Life

Click the Home Life button in the Member Info section.
Type in a response for ‘How many people live in your home, including you?’
Select a response(s) for ‘Who lives in your home with you?’. Select all that apply, as there are many choices.
Select a response for ‘What is your current living arrangement?’ from the drop-down list.
Select Yes or No for ‘Have you been homeless at any time in the last 6 months?’. Select ‘Prefer not to answer’ if appropriate.
Select a response(s) for ‘Are you having any problems at home? (check all that apply)’. Select all that apply, as there are many choices.
1. If the ‘Do not have any of these problems' is not selected, then select Yes or No for ‘Would you like to discuss this with someone?’. Select ‘Prefer not to answer’ if appropriate.

Current Providers

Click the Current Providers button in the Member Info section.
Click the teal +Add button under ‘Current health/mental health care providers, including specialists’.
1. Enter a Name
2. Enter a Phone Number
3. Select Yes or No for ‘Do you want them to be part of your Care Team?’
4. If there are more care providers to add, repeat Step 2.
5. If there are any care providers to remove, click Remove next to that care provider.
Click Save.
1. All goals and corresponding dates will not be retained if you do not click Save.

Resources

Click the Resources button in the Member Info section.
Select all options that may apply under ‘Community Resources and Services Being Utilized’
1. For each option selected, there is a range of corresponding Services that will appear in the next column and be made available to select. Selection of these services is not required.
Select all options that may apply under ‘Needed Community Resources and Services’
1. For each option selected, there is a range of corresponding Services that will appear in the next column and be made available to select. Selection of these services is not required.

Service Plan

Click the Service Plan button in the Member Info section.
Type in a response for Member Goals.
Type in a response for Future Opportunities / Deferred Goals.
Click the teal +Add button under Short-term Goals; 0-3 Months.
1. Type in a response for Goal (box 1). Select a date from the calendar picker for the Initiated Date (box 5).
2. Type in a response for Intervention (box 2). Select a date from the calendar picker for the Targeted Date (box 6).
3. If there is progress to record, type in a response for Progress (box 3). If progress is recorded, select a date from the calendar picker for Updated Date (box 7).
4. If there is an outcome to record, type in a response for Outcome (box 4). If an outcome is recorded, select a date from the calendar-picker for Achieved (box 8).
5. If there are any more short-term goals to add, repeat Step 2.
6. If there are any short-term goals to be removed, click Remove next to that set of goals & dates.
Click the teal +Add button under Long-term Goals; 3-12 Months.
1. Type in a response for Goal (box 1). Select a date from the calendar picker for the Initiated Date (box 5).
2. Type in a response for Intervention (box 2). Select a date from the calendar picker for the Targeted Date (box 6).
3. If there is progress to record, type in a response for Progress (box 3). If progress is recorded, select a date from the calendar picker for the Updated Date (box 7).
4. If there is an outcome to record, type in a response for Outcome (box 4). If an outcome is recorded, select a date from the calendar-picker for Achieved (box 8).
5. If there are any more long-term goals to add, repeat Step 3.
6. If there are any long-term goals to be removed, click Remove next to that set of goals & dates.
Click the teal +Add button under Self Management Goals.
1. Type in a response for Goal (box 1). Select a date from the calendar picker for the Initiated Date (box 5).
2. Type in a response for Intervention (box 2). Select a date from the calendar picker for the Targeted Date (box 6).
3. If there is progress to record, type in a response for Progress (box 3). If progress is recorded, select a date from the calendar picker for the Updated date (box 7).
4. If there is an outcome to record, type in a response for Outcome (box 4). If an outcome is recorded, select a date from the calendar-picker for Achieved (box 8).
5. If there are any more Self Management goals to add, repeat Step 4.
6. If there are any self-managed goals to be removed, click Remove next to that set of goals & dates.
Click Save.
1. All goals and corresponding dates will not be retained if you do not click Save.

Health & Well-Being

Health Behaviours

Click Health Behaviors in the Health & Well-Being section.
Select a response for ‘In the past three months have you smoked cigarettes or used any form of tobacco (e.g. chew, dip, cigars, hookah and/or e-cigarettes)?’
Select a response for ‘Have you ever ridden in a car driven by someone (including yourself) that was high or was using alcohol or drugs?’
Select a response for ‘Does anyone in your home take opioids for an ongoing medical condition? (OxyContin, Hydrocodone, Codeine)’
Select Yes or No for ‘Do you lock your opioid medications in a medicine cabinet or other locked location?’
Select Yes or No for ‘Do you have a smoke detector in your home?’
Select Yes or No for ‘Do you have gas heating or appliances in your home?’
Select Yes or No for 'Do you have carbon monoxide detector in your home?'
Click Save.

Caregiver

Click Caregiver in the Health & Well-Being section.
Select Yes or No for ‘Do you have a caregiver that comes into the home, because of a health care problem, to provide you with assistance?’
Select Relative, Friend, or Agency for ‘Is caregiver a relative, friend or from an agency?’
Type in a response for Caregiver/Agency Name.
Type in a number for Caregiver/Agency phone number.
Type in a response for Caregiver/Agency Specialty.
Select Per Day or Per Week for ‘How many hours per day/week does caregiver come into your home?’. Then, type in a response.
Type in a response for ‘What items does your caregiver help with?’
Select Yes or No for ‘Do you need more help than you are receiving?’
1. If Yes, type in an explanation.

ADL / IADL

Click ADL / IADL in the Health & Well-Being section.
Select a response from the Independent – Cannot Do scale for Bathing.
1. Select Yes or No in the Receiving Help column for Bathing.
Select a response from the Independent – Cannot Do scale for Dressing.
1. Select Yes or No in the Receiving Help column for Dressing.
Select a response from the Independent – Cannot Do scale for Grooming.
1. Select Yes or No in the Receiving Help column for Grooming.
Select a response from the Independent – Cannot Do scale for Mouth care.
1. Select Yes or No in the Receiving Help column for Mouth care.
Select a response from the Independent – Cannot Do scale for Toileting.
1. Select Yes or No in the Receiving Help column for Toileting.
Select a response from the Independent – Cannot Do scale for Transferring bed/chair.
1. Select Yes or No in the Receiving Help column for Transferring bed/chair.
Select a response from the Independent – Cannot Do scale for Walking.
1. Select Yes or No in the Receiving Help column for Walking.
Select a response from the Independent – Cannot Do scale for Climbing stairs.
1. Select Yes or No in the Receiving Help column for Climbing stairs.
Select a response from the Independent – Cannot Do scale for Eating.
1. Select Yes or No in the Receiving Help column for Eating.
Select a response from the Independent – Cannot Do scale for Shopping.
1. Select Yes or No in the Receiving Help column for Shopping.
Select a response from the Independent – Cannot Do scale for Managing medications.
1. Select Yes or No in the Receiving Help column for Managing medications.
Select a response from the Independent – Cannot Do scale for Using phone book/looking up numbers.
1. Select Yes or No in the Receiving Help column for Using phone book/looking up numbers.
Select a response from the Independent – Cannot Do scale for Doing housework.
1. Select Yes or No in the Receiving Help column for Doing housework.
Select a response from the Independent – Cannot Do scale for Doing laundry.
1. Select Yes or No in the Receiving Help column for Doing laundry.
Select a response from the Independent – Cannot Do scale for Driving or using public transportation.
1. Select Yes or No in the Receiving Help column for Driving or using public transportation.
Select a response from the Independent – Cannot Do scale for Managing finances.
1. Select Yes or No in the Receiving Help column for Managing finances.
Click Save.

Sleep

Click Sleep in the Health & Well-Being section.
Type in a response for ‘On average how many hours of sleep do you get in a 24 hour period’.
Select Yes or No for ‘Do you feel your sleep is restful?’

Employment

Click Employment in the Health & Well-Being section.
Select a response for ‘What is your current type of employment?’ from the ‘Employed – Full time’ – ‘Not in labor force’ scale. Select ‘Prefer not to answer’ if appropriate.
1. If Not Employed, select a response(s) for question 1a. Select all that apply.
2. If Employed, type in a response for question 1b.
Click Save.

D.M.E.

Click D.M.E. in the Health & Well-Being section.
Select a response from the Have – Don’t Need scale for any of the listed medical equipment (questions 1-23).
1. Click the teal, column-heading buttons in order to select the same response for questions 1-23. The select-all functionality can be used as a starting point if nearly all the answers will be the same.
Select Yes or No for ‘Do you have other adaptive equipment that is not listed above?’
1. If Yes, type in a description.
Select Yes or No for ‘Do you want other adaptive equipment that is not listed above?’
1. If Yes, type in a description.
Click Save.

Legal

Click Legal in the Health & Well-Being section.
Select Yes or No for ‘Do you have an advance directive and/or living will?’. Select ‘Don’t Know’ if appropriate.
1. If Yes, select Yes or No for ‘Do you have a copy of your advance directive and/or living will to put in your record?’
Select Yes or No for ‘Do you have a psychiatric advance directive?’. Select ‘Don’t Know’ if appropriate.
1. If Yes, select Yes or No for ‘Do you have a copy of your advance directive and/or living will to put in your record?’
Select Yes or No for ‘Have you given Power of Attorney (POA) to someone?’.
1. If Yes, type in a response for whom.
2. If Yes, select Yes or No for ‘Do you have a copy of your POA to put in your record?’
Select a response for ‘In the past six months, have you been arrested?’
Select a response for ‘In the past six months, were you the victim of any violent crimes, such as assault, rape, mugging, or robbery?’

Safety/Injuries

Click Safety/Injuries in the Health & Well-Being section.
Select Yes or No for 'Do you have a gun/firearm in the home?'
1. If yes, answer 1a and 1b
Select Yes or No for ‘During the past 12 months did you smoke any marijuana or hashish?’
Select Yes or No for ‘During the past 12 months did you use anything else to get high (includes illegal drugs, over-the-counter and prescription drugs, and things you sniff or huff)?'
If Yes was chosen for either question regarding use of drugs, answer the following. Otherwise, leave blank.
1. Select Yes or No for ‘Do you use drugs to relax, feel better about yourself or fit in?’
2. Select Yes or No for ‘Do you ever use drugs while you're by yourself, alone?’
3. Select Yes or No for ‘Have you ever gotten into trouble while you were using drugs?’
4. Select Yes or No for ‘Do you ever forget things you did while using drugs?’
5. Select Yes or No for ‘Does your family or friends ever tell you that you should cut down on your drug use?’

Future Plans

Click Future Plans in the Health & Well-Being section.
Type in a response for ‘What are your/your child's future plans for additional schooling, having a family, and career goals?’

Financial Support

Select Yes or No for ‘In the past six months, did you generally have enough money each month to cover food?’
Select Yes or No for ‘In the past six months, did you generally have enough money each month to cover clothing?’
Select Yes or No for ‘In the past six months, did you generally have enough money each month to cover housing?’
Select Yes or No for ‘In the past six months, did you generally have enough money each month to cover traveling around to get things, shopping, medical appointments, or visiting friends or relatives?’
Select Yes or No for ‘In the past six months, did you generally have enough money each month to cover social activities like movies or eating in restaurants?’
Select Yes or No for ‘In the past six months, did you generally have enough money each month to cover Heating, air conditioning, water, electricity, gas?’
Select Yes or No for ‘Have you received mental health or developmental disability services?’
Select Yes or No for ‘Do you have questions you would like to discuss with your provider?’
Select Yes or No for ‘Do you know what benefits are available to you?’
Select Yes or No for ‘Do you feel your benefits meet your needs?’

Clinical Summary

Allergies

Click Allergies in the Clinical Summary section.
Select Yes or No for Medication allergies.
1. If Yes, type in a response for ‘what are they?’
Select Yes or No for Food allergies.
1. If Yes, type in a response for ‘what are they?’
Select Yes or No for Environmental allergies (hay fever, dust, etc.).
1. If Yes, type in a response for ‘what are they?’
Type in a Pharmacy Name.
1. If a Pharmacy Name is provided, type in the Pharmacy Location.
2. If a Pharmacy Name is provided, type in the Pharmacy Phone Number.
Click the +Add button to enter the current medication information.
1. Type the name of the Medication.
2. Type the Dose.
3. Type in a response for ‘How often do you take them?’
4. Pick a date from the calendar picker for medication Start Date.
5. Type in a response for ‘What are they for?’
6. To add another medication, repeat step #6.
7. To remove a medication, click the Remove button next to that entry.
Click the +Add button to enter the previous medication information.
1. Only list atypical anti-psychotics from the following: Risperdal (Risperidone), Seroquel (Quetiapine), Geodon (Ziprasidone), Zyprexa (Olanzapine), Invega (Paliperidone), Saphiris (Asenipine), Clozaril (Clozapine), Abilify (Aripiprazole), Latuda (Lurasidone), Vraylar (Cariprazine), Rexulti (brexpiprazole).
2. Type the name of the Medication.
3. Type the Dose.
4. Type in a response for ‘How often do you take them?’
5. Pick a date from the calendar picker for the medication Start Date.
6. Pick a date from the calendar picker for the medication End Date.
7. Type in a response for ‘What are they for?’
8. To add another previous medication, repeat step #7.
9. To remove a medication, click the Remove button next to that entry.
Click Yes or No for ‘Now or in the past 6 months, have you taken any prescribed medications for emotional or behavioral symptoms?’
1. If Yes, Select Yes or No for ‘Have the medications helped you feel better?’
  1. If Yes, type in a response for ‘In what ways have they helped?’
2. If Yes, select Yes or No for ‘In the past 6 months have you had any bad side effects from these medications?’
  1. If Yes, type in a response for ‘What were the bad side effects?’
Click the +Add button to enter the over-the-counter medication information.
1. Type the name of the Medication, herb, vitamin, or supplement.
2. Type the Dose.
3. Type in a response for ‘How often do you take them?’
4. Pick a date from the calendar picker for the medication Start Date.
5. Type in a response for ‘What are they for?’
6. To add another over-the-counter medication, repeat step #9.
7. To remove an over-the-counter medication, click the Remove button next to that entry.
Select a response from the ‘Do not have to take medicine’ – ‘Seldom take as prescribed’ for ‘Do you have trouble taking medications as prescribed?’
1. If taking medication, select Yes or No for ‘Do you want help with this?’
Click the +Add button to enter other treatments (counseling, psychotherapy, OT, PT, chiropractor, acupuncture, traditional healing, other).
1. Type in a response for other treatments.
2. To add another treatment, repeat step #11.
3. To remove a treatment, click the Remove button next to that entry.
Click Save.

Medical/ Behavioral Health History

Click Health History in the Clinical Summary section.
For questions 1-76, click Past, Present, or both for ‘Condition/Behavior - Do you have or have you ever had:’.
1. If you select Present or both Past and Present for questions 1-76, select a response from Yes – No for ‘how much are you bothered by this condition/behavior?’
2. If you select Present, Past, or both Past and Present for questions 1-76, select Yes or No for ‘Would you like to talk about this with your provider?’
Select Yes or No for ‘Problems with teeth’.
Select Yes or No for ‘Problems with gums.
Select Yes or No for ‘Difficulty chewing’.
Select Yes or No for ‘Difficulty swallowing.
Select Yes or No for ‘Appetite change last six months’.
Select Yes or No for ‘Weight loss’.
Select Yes or No for ‘Weight gain’
If the client is male:
1. Select Yes or No for ‘Penis discharge’.
2. Select Yes or No for ‘Sore on penis’.
3. Select Yes or No for Erectile dysfunction.
4. Select Yes or No for ‘Testicular lump’.
5. Select Yes or No for Vasectomy.
6. Select Yes or No for PSA.
  1. If Yes, select a date for the PSA from the calendar picker.
7. Select Yes or No for ‘Prostate problems’.
8. Select Yes or No for ‘Prostate exam’.
  1. If Yes, select a date for the exam from the calendar picker.
9. Click Save.
If the client is female:
1. Enter a number for ‘Period started at age:’
2. Enter a number for ‘Number of pregnancies:’
3. Enter a number of ‘Number of live births:’
4. Enter a number for ‘Number of miscarriages:’
5. Select Yes or No for ‘Birth Control’
  1. If yes, specify which birth control.
6. Select Yes or No if the client has had a ‘Hysterectomy'
7. Select Yes or No if the client has had a 'PAP'.
  1. If Yes, indicate the date of the last PAP smear.
8. Select Yes or No if the client has had a ‘Mammogram.’
  1. If Yes, indicate the date of the last mammogram.

E.R. Visits

Click E.R. Visits in the Clinical Summary section.
Click the teal +Add button to enter an E.R. Visit.
1. Select a Month/Year from the calendar picker.
2. Type in a Reason for the E.R. Visit.
3. To add another E.R. Visit, repeat step #2.
4. To remove an E.R. Visit, click Remove next to that entry.
Click Save.

Surgeries

Click Surgeries in the Clinical Summary section.
Click the teal +Add button to enter a Surgery.
1. Select a Month/Year from the calendar picker.
2. Type in a Reason for the Surgery.
3. To add another Surgery, repeat step #2.
4. To remove a Surgery, click Remove next to that entry.
Click Save.

Substance Abuse Treatments

Click Substance Abuse Treatments in the Clinical Summary section.
Click the teal +Add button to enter a Substance Abuse Treatment.
1. Select a Month/Year from the calendar picker.
2. Type in a Reason for the Substance Abuse Treatment.
3. To add another Substance Abuse Treatment, repeat step #2.
4. To remove a Substance Abuse Treatment, click Remove next to that entry.
Click Save.

Immunizations

Click Immunizations in the Clinical Summary section.
Select Yes or No for ‘Up to date?’. Select ‘Don’t know/Not sure’ or ‘Refused’ if appropriate.
Select Yes or No for ‘During the past 12 months have you had either a flu shot or a flu vaccine that was sprayed into your nose?’. Select ‘Don’t know/Not sure’ or ‘Refused’ if appropriate.
Select Yes or No for ‘A pneumonia shot or pneumococcal vaccine is usually given only once or twice in a person’s lifetime and is different from the flu shot. Have you ever had a pneumonia shot?’. Select ‘Don’t know/Not sure’ or ‘Refused’ if appropriate.
Select Yes or No for Chicken Pox. Select ‘Don’t Know/Not Sure’ or ‘Within last 10 years’ if appropriate.
Select Yes or No for DTaP (diptheria, tetanus, acellular pertussis; 5 doses at 2, 4 6, 15 -18 mo & 4-6 yrs; <7 yrs). Select ‘Don’t Know/Not Sure’ or ‘Within last 10 years’ if appropriate.
Select Yes or No for Influenza (annual dose beginning at 6 mos). Select ‘Don’t Know/Not Sure’ or ‘Within last 10 years’ if appropriate.
Select Yes or No for Hepatitis A (2 doses; and 18-23 mos). Select ‘Don’t Know/Not Sure’ or ‘Within last 10 years’ if appropriate.
Select Yes or No for Hepatitis B (3 doses, birth, 1 to 2 mo & 6 to 18 mos). Select ‘Don’t Know/Not Sure’ or ‘Within last 10 years’ if appropriate.
Select Yes or No for Hib (Haemophilus influenzae type b; 4 doses at 2, 4, 12, or 15 mos). Select ‘Don’t Know/Not Sure’ or ‘Within last 10 years’ if appropriate.
Select Yes or No for HPV (Human Papilloma Virus; ages 11 to 26 females; ages 11 to 21 males). Select ‘Don’t Know/Not Sure’ or ‘Within last 10 years’ if appropriate.
Select Yes or No for IPV (Inactivated poliovirus; 4 doses ; 2, 4, 6 -18 mos & 4-6 yrs; <18 yrs). Select ‘Don’t Know/Not Sure’ or ‘Within last 10 years’ if appropriate.
Select Yes or No for MMR (measles, mumps rubella; 2 doses 12-15 mos & 4-6 yrs). Select ‘Don’t Know/Not Sure’ or ‘Within last 10 years’ if appropriate.
Select Yes or No for Meningococcal (2 doses; 11-12 yrs and booster 16-18 yrs). Select ‘Don’t Know/Not Sure’ or ‘Within last 10 years’ if appropriate.
Select Yes or No for PCV13 (Pneumococcal conjugate; 4 doses at 2, 4, 6, 12 or 15 mos). Select ‘Don’t Know/Not Sure’ or ‘Within last 10 years’ if appropriate.
Select Yes or No for Shingles. Select ‘Don’t Know/Not Sure’ or ‘Within last 10 years’ if appropriate.
Select Yes or No for Td/Tdap (Tetanus, diphtheria, pertussis; 11 to 12 yrs; 10 yr boosters). Select ‘Don’t Know/Not Sure’ or ‘Within last 10 years’ if appropriate.
Click Save.

Hospitalizations

Click Hospitalizations in the Clinical Summary section.
Click the teal +Add button to enter a Medical/Psychiatric Hospitalization
1. Select a Month/Year from the calendar picker.
2. Type in a Reason for the Hospitalization.
3. To add another Hospitalization, repeat step #2.
4. To remove a Hospitalization, click Remove next to that entry.
Click Save.

Health Concerns

Click Health Concerns in the Clinical Summary section.
Select Yes or No for ‘Accident or injury prevention’.
Select Yes or No for ‘Ear, eye or mouth care’.
Select Yes or No for ‘Exercise and nutrition’.
Select Yes or No for ‘Health screening tests’.
Select Yes or No for ‘Money, housing case management’.
Select Yes or No for ‘Living will, end-of-life issues’.
Select Yes or No for ‘Long term care needs’.
Select Yes or No for ‘Family or personal problems’.
Select Yes or No for ‘Depression or other mental concerns’.
Select Yes or No for ‘Preventing cancer’.
Select Yes or No for ‘Preventing heart disease’.
Select Yes or No for ‘Problems with my healthcare’.
Select Yes or No for Other.

Care Plan Consent

Click Care Plan Consent in the Clinical Summary section.
A history of signatures is displayed at the top of the questionnaire. If no signatures have been provided, there will be nothing in the Member and/or Guardian Consent – History section.
Type in a Member and/or Guardian Name. This will serve as the Member and/or Guardian’s signature.
Select a date from the calendar picker for the Member and/or Guardian.
Type in a Care Coordinator Name. This will serve as the Care Coordinator’s signature.
Select a date from the calendar picker for the Care Coordinator.
Select Acknowledged.
Click Save.
1. The most recent set of signatures will appear on the client’s Care Plan. This can be seen by clicking the blue ‘View Care Plan’ button in the Clinical Summary section.

View Care Plan

Click the blue ‘View Care Plan’ button in the Clinical Summary section.
1. The client’s care plan is displayed. Information from several of the questionnaires can be seen here, including the electronic signatures provided in the Care Plan Consent questionnaire.

View CNA

Click the ‘View CNA’ button from the Clinical Summary section.
1. The client’s entire CNA is displayed. Information from all the questionnaires can be seen here. The CNA is formatted to be printer-friendly.

Submit a new Clinical Screen Survey/View completed Clinical Screen Survey(s)

Click View to see the answers for the Clinical Screen Survey on that date (changes to answers on a completed survey are not allowed).

Click the green plus sign in the top right of the Clinical Screen Survey box.
Answer Clinical Screen Survey questions. Click Save to submit answers or Cancel to return to the Assessments tab.
1. If a new Clinical Screen Survey was completed, an entry will appear in the Clinical Screen Survey box with the date of the survey along with an orange plus under any of the columns (Depression, Survey, Suicide, Anxiety, Alcohol and/or PTSD) that were flagged during after submitting the Clinical Survey answers.