
Prevention Needs:		Center Health Profile
	Need Hearing Screen		No Regular Doctor
	Need Mammogram (of females)		Cannot Care for Self
	Alcohol Risk
	Need Dental Exam	Chronic/Disabling Conditions
	Need Prostate Exam (of males)		Arthritis
	Need Eye Exam		Hypertension
	Smoking Risk		Heart Disease
	Seat Belt Risk		Diabetes
	No Smoke Alarm
	Need Blood Pressure Check	Medication Risk:
			Take 3 or more prescription meds
Mental Health Risk:			Take over the counter meds
	Lost Someone Close		Take herbal supplements
	Feel Sad		Take nerve medicine
	Feel Life Is Empty		Take sleep medicine
	Feel Something Bad Is Going To		Take pain medicine
	Happen		Think medicine has lost
	Lost Interest In Activities And		effectiveness
	Hobbies		Sometimes forget to take
	Harm Risk		medicine
			Go to more than one drug store
			for meds
Fall Risk:
	Blood Pressure Pills
	Heart Pills		Every Healthy Town Link
	Recent Fall		on One Page
	Eye Drops
	Light-headed		References
	Use Assistive Device

Immunization Risk:
	Need TB Screen
	Need Tetanus Shot
	Need Pneumonia Shot
	Need Flu Shot

Nutritional Risk:
	Wears False Teeth
	Does Not Eat Three Meals/Day
	On Special Diet
	Tooth/Mouth Problems
	Need Money for Food

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The Visiting Nurse Association Healthcare Partners of Ohio disclaims any liability with
this web site. It is not intended for use without review and judgment of medical professionals.