| Category | Preventives | To Do |
| CHEMOPROPHYLAXIS | MULTIVITAMIN WITH FOLIC ACID | TO BE DONE |
| DISCUSS HORMONE PROPHYLAXIS | TO BE DONE |
| DENTAL HEALTH | REGULAR VISITS TO DENTAL CARE PROVIDER | TO BE DONE |
| FLOSS, BRUSH WITH FLUORIDE TOOTHPASTE DAILY | TO BE DONE |
| DIET AND EXERCISE | LIMIT CHOLESTEROL & FAT,MAINTAIN CAL. BALANCE | TO BE DONE |
| REGULAR PHYSICAL ACTIVITY | TO BE DONE |
| ADEQUATE CALCIUM INTAKE | TO BE DONE |
| HIGH RISK | LOW INCOME; IMMIGRANTS | PPD |
| TB CONTACTS | PPD |
| NATIVE AMERICAN/ALASKA NATIVE | HEPATITIS A VACCINE; PPD; PNEUMOCOCCAL VACCINE |
| TRAVELERS TO DEVELOPING COUNTRIES | HEPATITIS B VACCINE; HEPATITIS A VACCINE |
| CERTAIN CHRONIC MEDICAL CONDITIONS | PPD; PNEUMOCOCCAL VACCINE; INFLUENZA VACCINE |
| FAMILY H/O SKIN CANCER; NEVI; FAIR SKIN, | AVOID MIDDAY SUN; USE PROTECTIVE CLOTHING |
| HIGH RISK SEXUAL BEHAVIOR | RPR; CHECK FOR GC & CHLAMYDIAI(FEMALE);HIV; HEP A& B |
| INJECTION OR STREET DRUG USE | RPR; HIV SCREEN; HEPATITIS A & B VACCINE; PPD |
| SUSCEPTIBLE TO VARICELLA, MEASLES, MUMPS | MMR; VARICELLA VACCINE |
| BLOD TRANSFUSION BETWEEN 1978-1985 | HIV SCREEN; HEPATITIS B VACCINE |
| INSTITUTIONALIZED PERSONS; HEALTH CARE WORKERS | HEPATITIS A VACCINE; PPD; PNEUMOCOCCAL VACCINE |
| PREVIOUS PREGNANCY WITH NEURAL TUBE DEFECT(FEMALE | FOLIC ACID 4 MG |
| IMMUNIZATIONS | RUBELLA | TO BE DONE |
| INJURY PREVENTION | LAP-SHOULDER BELTS | TO BE DONE |
| BICYCLE HELMET, AVOID BICYCLING NEAR TRAFFIC | TO BE DONE |
| SMOKE DETECTOR, FLAME RETARDANT SLEEPWEAR | TO BE DONE |
| SAFE STORAGE- DRUGS,TOXIC SUBSTANCES,FIREARMS MAT | TO BE DONE |
| MOTORCYCLE/ATV HELMETS | TO BE DISCUSSED |
| SAFE STORAGE/REMOVAL OF FIREARMS | TO BE DONE |
| SCREENING | HEIGHT AND WEIGHT | TO BE DONE |
| BLOOD PRESSURE | TO BE DONE |
| VISION SCREEN | TO BE DONE |
| PAPANICOLAOU (PAP) TEST(FEMALE ONLY) | TO BE DONE |
| RUBELLA SEROLOGY OR VACCINATION HX(FEMALE ONLY) | TO BE DONE |
| ASSESS FOR PROBLEM DRINKING | TO BE DONE |
| SEXUAL BEHAVIOR | STD PREVENTION: ABSTINENCE | TO BE DONE |
| UNINTENDED PREGNANCY: CONTRACEPTION (FEMALE ONLY) | TO BE DONE |
| SUBSTANCE ABUSE | TOBACCO CESSATION | TO BE DONE |
| AVOID ALCOHOL/DRUG USE WHILE DRIVING,BOATING | TO BE DONE |
