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4310 Medical Parkway, Suite 103 Austin, TX 78756 512.459.1272 !!dlyonsphd gmail.com www.deborahslyonsphd.comTodays Date: CHILD AND ADOLESCENT PATIENT HISTORY FORM Last Name:First Name: DOB:Gender:Age:Race:Referred
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How to fill out child and adolescent patienthistory
How to fill out child and adolescent patienthistory
01
Start by including the patient's personal information such as name, date of birth, and contact details.
02
Provide a detailed medical history of the child or adolescent, including any past diagnoses, treatments, and surgeries.
03
Mention any known allergies or adverse reactions to medications.
04
Include a family medical history, highlighting any genetic disorders or hereditary conditions.
05
Document the patient's immunization history, including the dates and types of vaccines received.
06
Record the patient's growth and development milestones, such as height, weight, and motor skills.
07
Assess the patient's psychosocial history, including any behavioral or emotional concerns.
08
Include any relevant laboratory or diagnostic test results.
09
Sign and date the patient history form to indicate its completion.
10
Review the filled-out form for accuracy and completeness before filing it in the patient's medical records.
Who needs child and adolescent patienthistory?
01
Child and adolescent patient history forms are required for any healthcare provider or medical professional who is involved in the care of children and adolescents.
02
This includes pediatricians, general practitioners, pediatric nurses, child psychologists, and other specialists who work with children and adolescents.
03
By having a comprehensive patient history, healthcare professionals can better understand their patients' medical background and provide appropriate care and treatment.
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What is child and adolescent patienthistory?
Child and adolescent patient history refers to the medical history of patients who are under the age of 18.
Who is required to file child and adolescent patienthistory?
Healthcare providers and medical professionals who are treating children and adolescents are required to file child and adolescent patient history.
How to fill out child and adolescent patienthistory?
Child and adolescent patient history can be filled out by gathering information on the patient's previous medical conditions, current symptoms, family medical history, and any medications they are currently taking.
What is the purpose of child and adolescent patienthistory?
The purpose of child and adolescent patient history is to provide healthcare providers with important information about the patient's medical background, which can help in making accurate diagnoses and treatment plans.
What information must be reported on child and adolescent patienthistory?
Information such as previous medical conditions, current symptoms, family medical history, and medications being taken must be reported on child and adolescent patient history.
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