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Duke Integrative Medicine Pediatric Functional Medicine Intake Dear Caregiver, Thank you for taking time to fill out this questionnaire. It is extensive, but history plays a vital role in Functional
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How to fill out pediatric functional medicine intake

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How to fill out pediatric functional medicine intake

01
Step 1: Begin by gathering all necessary documents and medical history related to the pediatric patient.
02
Step 2: Start by filling out the basic demographic information of the patient, including name, age, gender, and contact details.
03
Step 3: Move on to recording the chief complaints or reason for seeking pediatric functional medicine intake.
04
Step 4: Detail the patient's complete medical history, including previous diagnoses, treatments, and surgeries if applicable.
05
Step 5: Document any known allergies or sensitivities the patient may have.
06
Step 6: Proceed with a thorough family medical history, noting any genetic conditions or hereditary diseases.
07
Step 7: Provide information about the patient's lifestyle, including diet, sleep patterns, exercise routines, and stress levels.
08
Step 8: Include details about the patient's current medications, supplements, or any other ongoing treatments.
09
Step 9: Note any specific concerns or goals the patient or their guardian may have for the functional medicine intake.
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Step 10: Finally, sign and date the intake form to complete the process.

Who needs pediatric functional medicine intake?

01
Pediatric patients who require a comprehensive and holistic approach to healthcare
02
Children with chronic or recurring health issues
03
Those seeking alternative or integrative medicine options for their child's well-being
04
Individuals interested in addressing the root causes of health problems rather than just treating symptoms
05
Parents or guardians who prefer a personalized and individualized approach to their child's healthcare.
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Pediatric functional medicine intake is a comprehensive evaluation of a child's health history, lifestyle, and symptoms to identify underlying root causes of health issues.
Parents or caregivers of children seeking a holistic approach to healthcare may be required to fill out pediatric functional medicine intake forms.
Parents or caregivers need to provide detailed information about the child's medical history, dietary habits, lifestyle factors, and current symptoms in the pediatric functional medicine intake form.
The purpose of pediatric functional medicine intake is to create a personalized health plan that addresses the root causes of health issues and promotes overall wellness in children.
Information such as the child's medical history, family history, current symptoms, dietary habits, lifestyle factors, and any previous treatments should be reported on pediatric functional medicine intake forms.
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