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SLOW MEMORIAL HOSPITAL Rehabilitation Services PEDIATRIC PATIENT MEDICAL HISTORY Child's Name: Date of Birth: Age: Physician: Parent/Caregiver/Legal Guardian: Address: Phone: (home) (mobile) (work)

How to fill out pediatric patient medical history

How to fill out pediatric patient medical history:

1. Begin by gathering all necessary information about the child's medical history. This includes previous illnesses, surgeries, allergies, and medications.
2. Record any relevant family medical history, such as genetic disorders or chronic conditions, as these can provide important insights into the child's health.
3. Include information about the child's growth and development milestones, such as when they started walking, talking, or achieving other key developmental markers.
4. Document any current or ongoing medical conditions, such as asthma, diabetes, or allergies, and note the severity and any treatments or medications being used.
5. Provide information on the child's immunization history, including dates of vaccinations and any adverse reactions.
6. Ask about the child's dietary habits, including any specific food preferences, restrictions, or intolerances.
7. Inquire about the child's sleep patterns, including the number of hours they typically sleep each night and any issues or difficulties they may have with sleep.
8. Record any behavioral or psychological concerns, such as anxiety, learning disabilities, or behavioral issues that may impact their overall well-being.

Who needs pediatric patient medical history:

1. Pediatricians and healthcare providers require the child's medical history to gain a comprehensive understanding of their health and provide appropriate care.
2. Parents and guardians should also have access to their child's medical history, as it can help them make informed decisions about their child's healthcare and communicate effectively with healthcare professionals.
3. Schools and childcare facilities may ask for a child's medical history to ensure their safety and provide appropriate accommodations or interventions if needed.

In summary, filling out a pediatric patient's medical history involves documenting any relevant information about the child's health, including past illnesses, current conditions, growth and development milestones, immunization history, dietary habits, sleep patterns, and behavioral concerns. This information is needed by pediatricians, parents, and caregivers to ensure the child receives appropriate healthcare and support.

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