Patient Registration Form and "Form reviewed by" Immunization Questionnaire

[nwlandas]

For the Immunization Questionnaire, I'm not sure who is supposed to review the form. A parent?



I also have a couple of questions about the Patient Registration Form. Why is there only one page? What format should the "Date of Birth" section be in (YYYYMMDD)? Thanks.

 

[pnwpandas]

Top form will be reviewed by someone at USNA, I presume. Bottom form date of birth format should be standard MMDDYYYY. Ex. 01/01/2021. Page 2 is instructions, if you're referring to form DD3111. Page 2 for the other form NHCLA 6150/24 concerns insurance. It also explains that the FMP (Family Member Prefix) "20" coding stands for active duty/retiree that you see next to the SSN box and Patient FMP box.