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CLEFT CARE UK 20102012Study number:A1 ID Number___A2 Today's date//YOU AND YOUR FAMILY B1 Child's date of birth://B2A Is this child:Male1Female2B3A Are you the children:Mother1Father2Someone else3Who,
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01
Obtain a cleft care companion an form from a healthcare provider or cleft care organization.
02
Fill in your personal information, including your name, contact information, and date of birth.
03
Provide details about your cleft condition, including any surgeries or treatments you have received.
04
Include information about any medications you are currently taking or allergies you may have.
05
List any healthcare providers who are involved in your cleft care, including their names and contact information.
06
Sign and date the form to indicate that the information provided is accurate and up to date.

Who needs cleft care companion an?

01
Individuals who have a cleft lip or palate and are seeking coordinated care from healthcare providers.
02
Family members or caregivers of individuals with a cleft condition who are involved in their medical care.
03
Healthcare providers who are treating patients with cleft lip or palate and need to collaborate with other providers for comprehensive care.
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Cleft Care Companion AN is a support program designed to assist individuals with cleft lip and palate in navigating their treatment journey.
Patients with cleft lip and palate, along with their caretakers or guardians, are required to file Cleft Care Companion AN.
Cleft Care Companion AN can be filled out online through the program's website or by requesting a hard copy form from a healthcare provider.
The purpose of Cleft Care Companion AN is to provide resources, information, and support to individuals with cleft lip and palate to improve their treatment outcomes and overall quality of life.
Information such as medical history, treatment plans, medications, and any challenges or concerns related to cleft lip and palate must be reported on Cleft Care Companion AN.
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