TX HHS Form 2001. Interagency Eye Examination Report

The TX HHS Form 2001, Interagency Eye Examination Report, is a crucial tool for healthcare professionals to document patient information and ocular history. This form helps solve the problem of ensuring that patients receive appropriate eye care services by providing a standardized format for recording visual acuity, ocular diseases, and injuries.

The report consists of three sections: Patient Information, Ocular History, and Visual Acuity. The first section requires the patient's name, date of birth, street address, city, state, and ZIP code, as well as the parent's or spouse's name and home phone number. The second section asks for a description of the ocular history, including eye diseases, injuries, or operations. The third section allows healthcare professionals to record visual acuity measurements using Snellen acuities or equivalents.

Key features of this form include the requirement for starred items indicating required information and the importance of thoroughness in completing the report. This ensures that patients receive appropriate services and that healthcare professionals can accurately document patient information. The form is typically filled out by eye care specialists, and its use is essential for providing quality eye care to patients.

• The TX HHS Form 2001 is used to document patient information and ocular history.
• The report consists of three sections: Patient Information, Ocular History, and Visual Acuity.
• Required information includes the patient's name, date of birth, street address, city, state, and ZIP code.