Completing a Confidential Health Intake Form

Objectives:

• The learner will complete a sample Confidential Health Intake Form with fewer than three errors.

• The learner will define lesson vocabulary.

Duration:

     2 hours

Materials:

• Confidential Health Intake form

• Patient Profiles

• Vocabulary sheet

Activities:

1. Teacher introduces lesson vocabulary, modeling correct pronunciation; students repeat (three times).

2. Learners receive intake forms, patient profiles (one each) and activity instructions.

3. Learners use patient profile to fill out the intake form.

4. Teacher meets with each student to monitor written responses.

5. Learners exchange forms with each other and describe to the class the patient they receive by reading the form.

Assessment:

Teacher monitors verbal responses, meets individually with each learner to evaluate written work.