Medical Records (Chapter 4) Part 2

  1. All records are verified (when) by medical and dental personnel having custody of them.
  2. A member's health records may be closed due to what following circumstances?
    • 1. Death or declared death
    • 2. Discharge
    • 3. Resignation
    • 4. Release from active duty
    • 5. Retirement
    • 6. Transfer to the Fleet Reserve or release to in active duty
    • 7. Missing or MIA
    • 8. Desertion
    • 9. Disenrollment as an officer candidate or midshipman
  3. When duplicating an entire health record, place the designation "______" prominently on the front of the jacket aboce the wording OUTPATIENT MEDICAL RECORD.
  4. When duplicating only part of the record, identify the individual forms by printing "_____" at the bottom of each form.
  5. If reasonable search efforts do not locate the record, retain loose forms for a period of 1 year.
    True of False.
  6. What is a DD 2766?
    Adult Preventive and Chronic Care Flow Sheet
  7. If a patient has "Allergies" or significant reactions to medications; Where on the DD Form 2766 do you enter them?
    In the Medical alert section
  8. What is the purpose of a SF 600?
    Provides a continuous comprehensive record of a patient's medical history.
  9. What is the SF 509 used for?
    SF 509 Medical Record-Progress Report; This form is routinely used for inpatient admission notes and is filed in the patient's IREC.
  10. The name of the medical officer or SMDR administering the immunization, test, or determining the nature of the sensitivity reaction should ce typed or written on the DD Form 877.
    True or False
    • False
    • *DD Form 2766
  11. What is a PHS-731 form?
    International Certificates of Vaccination
  12. What is NAVMED 6150/4?
    Abstract of Service and Medical History
  13. What is a DD Form 1141?
    Record of Occupational Exposure to Ionizing Radiation
  14. What form is used to summarize clinical data relative to treatment received during periods of hospitalization?
    SF 502 Narrative Summary
  15. The SF 539 may be used as a substitute for the narrative summary.
    True or False.
  16. What form is used for outpatients who need to be referred to other healthcare providers or specialists, such as gynecologist, internists, optometrists, etc.?
    SF 513- Consultation Sheet
  17. DD Form 771 is an Eyewear Prescription in a HREC. What does it consist of?
    3-carbon copy fom & 2-part cabonless form
  18. Part I (Inside Front Cover)
    Forms will be filed in the inside front cover of the dental record jacket as follows:
    - Sequential bitewing radiograph- Front
    - Panographic or full-mouth radiograph-middle
    -Un-mounted radiograph in envelopes- Back
    True or False
    • False
    • *Un-mounted radiographs in envelopes -FRONT
    • *Sequential bitewing radiograph -        MIDDLE
    • *Panographic or full-mouth radiograph -       BACK
  19. Where is the NAVMED 6600/3, Dental Health Questionnaire (HQR) placed?
    PART II (Front of Center Page)
  20. All Dental Exam Forms, EZ603s in reverse chronological order newest date on top are placed in Part IV(Inside Back Cover).
    True or False
    • False
    • *PART III (BACK of Center Page)
  21. The Current Status Form can be found in Part IV (Inside Back Cover)
    True or False
  22. The "Privacy ACT" permits only the patients and their legal representatives to obtain this information. Additional rotection is afforded under the (WHAT) rule?
    HIPAA Privacy Rule
  23. Records are retained in the custody of the Medical officer and or dental officer on the ship, submarine etc.
    True or False.
  24. The SEL may assign custody of the health records to the local representatives of the Medical and Dental Departments.
    True or False
    • FALSE
    • *CO
  25. Who can inspect Records at any time?
    • CO
    • Superiors in the chain of Command
    • Fleet Medical Officer
    • Other Authorized Inspectors
  26. The Medical Department personnel will maintain a (WHAT) for each health, outpatient, and dental record in their custody.
    • NAVMED 6150/7
    • Health Records Receipt, File Charge-out, and Disposition Record
  27. The Surgeon General of the Navy is the official responsible for administering and supervising the execution of (WHAT), as it pertains to the Health Care Treatment Record System.
    • SECNAVINST 5211.5 series
    • Department of the NAVY Privacy Act Program
  28. It is of the utmost importance that the HM learns and follows the guidelines for establishing, handling, maintaining, and closing medical and dental records.
    True or False
Card Set
Medical Records (Chapter 4) Part 2
Hospital Corpsman NAVEDTRA 14295B