HEALTH ASSESSMENT AND HEALTH PROMOTION

LONG ISLAND UNIVERSITY

HARRIET ROTHKOPF HEILBRUNN SCHOOL OF NURSING

BROOKLYN, NEW YORK

NUR 220L  ASSESSMENT AND HEALTH PROMOTION LAB

 *To be completed as Homework and submitted in Lab. Student will perform a Comprehensive Health History on an adult/older adult who has a medical condition and taking prescribed medications.  

Student Name:  ___________________________________                         Date:  ________________

Client’s Initials ________      Gender________   DOB________   Age________          Race_________________

Marital Status________    Nationality ________   Culture ________   Primary Language ________________

Religion ______________  Occupation____________________      Education________________________

Sexuality _____________  Height___________           Weight____________             BMI  _________________

Source of Data________________________________   Reliability of Source  ______________________________

Contact Person (Include relationship)