| Health Care Guidelines |
When |
| Physical exam |
One visit every 24 months; annually if desired
|
| Health guidance |
One visit annually for vision/glaucoma check, STI/HIV counseling, screen for tobacco use, alcohol misuse and family and intimate partner violence. |
Clinical screenings
|
When |
| Depression screening |
During physical exam |
| Tobacco use |
During each visit |
| Alcohol/drug misuse |
During each visit |
| Height, weight, BMI and blood pressure |
During physical exam; nutrition and physical activity counseling for those identified as high risk |
| Lipoprotein screening |
For all adults, a fasting lipoprotein profile (total cholesterol, LDL, HDL and triglyceride) should be obtained once every five years. |
| Diabetes screening |
Once every three years |
Tuberculin skin test (PPD)
|
For those identified as high risk |
| Hemoglobin and hematocrit |
Once every two years |
| Mammogram (women) |
Annually |
| Cervical cancer screening (women) |
Every two to three years. Suggest stopping at age 70 if three or more normal Pap tests in a row, no abnormal Pap test in previous ten years and not at high risk. |
Chlamydia screening and Gohorrhea screening (STIs)
|
All sexually active women to be screened for STIs |
HIV screening
|
Annually if you are at high risk
|
| Colorectal cancer screening |
One of the following screening options:
- Fecal occult blood test annually
- Flexible sigmoidoscopy every five years
- Fecal occult blood test annually and flexible sigmoidoscopy every five years
- Double-contrast barium enema every five years
- Colonoscopy every ten years
Those with a family history of colorectal cancer, or adenomatous polyps; colonoscopy every five years |
Osteoporosis risk factor assessment (women)
|
Routine beginning at age 65
Does not include bone density test
|
| Abdominal aortic aneurysm screening (men) |
Between ages 65 and 75 who have ever smoked, a one-time screening for abdominal aortic aneurysm. |
| Immunizations |
When |
Td/Tdap
Tetanus, diphtheria and pertussis vaccine |
Every 10 years (Give one dose of Tdap if pertussis booster was not received previously.)
|
HepA and HepB
Hepatitis A and Hepatitis B vaccines |
For high risk groups |
Var
Varicella (chickenpox) vaccine |
Two dose series at least four weeks apart if no history of varicella or previous vaccination.
|
Flu
Influenza vaccine |
Annually |
Pneumoccal
Pneumonia vaccine |
Once after age 65 |
Zoster
Shingles vaccine |
One dose at age 60 and older |
| Meningococcal |
If high risk |
| MMR |
If high risk |
