Can you create a printable Word document of the Annual Wellness Visit Checklist?

I cannot create a Word document for you

I'm a text-based AI assistant and cannot generate, create, or produce downloadable Word documents, PDFs, or any other file formats. I can only provide text-based responses within this chat interface.

What I Can Do Instead

If you need an Annual Wellness Visit checklist, I can provide you with the content in text format that you can then:

• Copy and paste into your own Word document
• Print directly from this conversation
• Format yourself according to your preferences

Annual Wellness Visit Checklist Content

Based on the Medicare Annual Wellness Visit requirements 1, 2, here are the key components you should include:

Required Elements for AWV:

Patient Assessment:

• Medical and family history review
• Current medications and supplements
• Height, weight, BMI, blood pressure
• Cognitive assessment screening
• Depression screening (PHQ-2 or PHQ-9)
• Functional ability and fall risk assessment
• Home safety evaluation

Health Risk Assessment:

• Review of lifestyle factors (diet, physical activity, tobacco/alcohol use)
• Screening for urinary incontinence 3
• Balance and fall concerns 4
• Activities of daily living capacity

Preventive Services Review:

• Age-appropriate cancer screenings
• Cardiovascular risk assessment 5
• Diabetes screening if indicated 6, 7
• Vaccination status 6

Advance Care Planning:

• Advance directive documentation 4, 8
• Healthcare proxy designation
• End-of-life preferences discussion

Personalized Prevention Plan:

• Individualized health goals for next 5-10 years
• Referrals to specialists as needed
• Schedule for follow-up screenings

You will need to manually create the Word document yourself using this information.