A fillable PDF has fields in which you can enter text.  The box for the field appears when you click or press the TAB key on your keyboard to the active field where you want to enter text.

We recommend you use the TAB key so you will not accidently miss any fields.  Either use your mouse to go to the next area where you wish to enter text and click when the little hand turns into an I-beam or press the TAB key on your keyboard.

• If you are using the Reader version, download a FREE copy of the most current Reader from Adobe.  Versions earlier than Adobe DC had a known problem with some PDF files displaying improperly.  CLICK HERE TO DOWNLOAD THE LATEST VERSION OF ADOBE READER DC.
• Click here for Adobe's Support Knolwedgebase: PDF Pages Don't Appear in Web Browser Window.

Click on the Print Form button at the bottom of the form.  When the Print box pops up, select your printer, click OK, and your form should print.

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EPSDT Helpdesk: 1-808-900-8650

• Hours of Operation: 8AM to 5PM (Monday to Friday)

The Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit is a federally mandated benefit under Title XIX of the Social Security Act. This benefit provides preventive and comprehensive health services for Medicaid-eligible individuals under age 21. The EPSDT benefit is provided to Medicaid-eligible infants, youth and participants up to the age of 21.  The primary goal is to offer prevention, early diagnosis and medically necessary treatment of conditions.

The DHS 8015 EPSDT Visit Matrix crosswalks 8015 form fields, each periodicity age visit, CDC vaccine schedule and AAP Bright Futures Recommendations.

https://medquest.hawaii.gov/content/dam/epsdt-graphics/job_aids/DHS%208015%20EPSDT%20Visit%20Matrix_4.1.2022.xlsx