# Medicare Wellness Health Risk Assessment



## patstrubberg (Jan 31, 2012)

Since Medicare now requires a Health Risk Assessment as part of the Medicare Wellness (effective 1-1-2012) vist I was wondering if anyone actually has a form they are using that they may want to share?  Evidently Part B news had a link to a form but i missed that altogether and can't seem to find it.   That is theone I would really like to see if you have it.  Thanks.  Pat


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## Evelyn Kim (Feb 13, 2012)

I would check with your Medicare Advantage carriers in the area, they should have a form for you to use.  I know we provider our providers with a form each year.


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## drooth (Mar 5, 2012)

I don't have Part B's sample test, but here are a couple:
http://mybraintest.org/dl/Sample_Medicare_Annual_Wellness_Visit_Exam_Form.pdf
and on page 43 of this link:
http://www.cdc.gov/policy/opth/hra/FrameworkForHRA.pdf


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