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PT/OT Pediatric Referral BAINBRIDGE ISLAND(206) 8426288 Fax: 8426292 945 Hildebrand Lane NE Suite #220 Bainbridge Island, WA 98110 Located in the same building as Swedish Primary CareBREMERTONwww.KitsapPT.com Name:___Phone:___
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Obtain the pediatric therapy form from the healthcare provider or facility.
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Fill out the patient's personal information, including name, date of birth, address, and contact details.
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Provide information about the child's medical history, including any existing conditions, surgeries, medications, and allergies.
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Include details about the child's developmental milestones, motor skills, communication skills, and any concerns or observations.
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Indicate the reason for seeking pediatric therapy services and any specific goals or expectations for the therapy.
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Sign and date the form as proof of consent and agreement to the terms.

Who needs pediatric formrapy services?

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Children who are experiencing developmental delays or challenges
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Children who require rehabilitation after surgery or injury
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Pediatric pharmacy services are specialized services provided to children by pharmacists who have received additional training in pediatric medicine.
Pharmacists who work with pediatric patients or in pediatric healthcare settings are required to provide pediatric pharmacy services.
Pediatric pharmacy services can be filled out by pharmacists with specialized training in pediatric medicine using specific protocols and guidelines.
The purpose of pediatric pharmacy services is to ensure that children receive appropriate medication therapy that is safe and effective for their age and health conditions.
Pediatric pharmacy services must include information on the child's diagnosis, medication dosage, frequency of administration, and any special instructions.
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