Family Information Notebook (FIN) - Vanderbilt Kennedy Center

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22 CHILD’S NAME: DATE OF BIRTH: INFORMATION FOR GENETIC FAMILY TREE Include your child’s siblings and parents, as well as aunts and uncles, nieces and nephews, grandparents, and cousins. The medical conditions column should include any instances of cancer, heart disease, diabetes, asthma, mental illness, high blood pressure, stroke, kidney disease, alcoholism, vision or hearing loss, learning problems, and mental retardation. The birth defects column should include instances of spina bifida, cleft lip, heart defects, and the like. RELATIVE’S NAME RELATIONSHIP BIRTH DATE DEATH DATE (IF APPLIES) MEDICAL CONDITION(S) AGE OF ONSET © Junior League Family Resource Center 2005 BIRTH DEFECT(S) ETHNIC ORIGIN JOB
23 SUGGESTED INFORMATION TO INCLUDE � Immunization Records provided by pediatrician/PCP � Growth Charts � Copies of Genetic Test Results � Copies of Genetic Family Tree © Junior League Family Resource Center 2005
Page 1 and 2: 1 Family Information Notebook (FIN)
Page 3 and 4: 3 TABLE OF CONTENTS Emergency Healt
Page 5 and 6: 5 INTRODUCTION TO EMERGENCY HEALTH
Page 7 and 8: CHILD’S NAME: DATE OF BIRTH: CURR
Page 9 and 10: CHILD’S NAME: DATE OF BIRTH: 9 BA
Page 11 and 12: CHILD’S NAME: DATE OF BIRTH: 11 A
Page 13 and 14: 13 MEDICAL POWER OF ATTORNEY I, ___
Page 15 and 16: 15 Health and Development • Intro
Page 17 and 18: CHILD’S NAME: DATE OF BIRTH: 17 M
Page 19 and 20: Eye Exams 19 CHILD’S NAME: DATE O
Page 21: At home: 21 CHILD’S NAME: DATE OF
Page 25 and 26: 25 INTRODUCTION TO DAILY ROUTINE Th
Page 27 and 28: CHILD’S NAME: DATE OF BIRTH: 27 S
Page 29 and 30: 1. Equipment: Who provides (agency,
Page 31 and 32: CHILD’S NAME: DATE OF BIRTH: 31 M
Page 33 and 34: CHILD’S NAME: DATE OF BIRTH: 33 P
Page 35 and 36: CHILD’S NAME: DATE OF BIRTH: 35 T
Page 37 and 38: 37 INTRODUCTION TO EDUCATION / SCHO
Page 39 and 40: CHILD’S NAME: DATE OF BIRTH: Name
Page 41 and 42: Doctor Nurse Teacher CHILD’S NAME
Page 43 and 44: � TEIS Evaluations and ISPs � C
Page 45 and 46: INTRODUCTION TO RESOURCES / OPTIONA
Page 47 and 48: Your Child’s Educational Rights:
Page 49 and 50: 49 Kay Flowers, Complaints Consulta
Page 51 and 52: 51 State Special Schools Tennessee
Page 53 and 54: 53 TENNESSEE DEPARTMENT OF CHILDREN
Page 55 and 56: 55 ADDITIONAL EDUCATION AND HEALTH
Page 57 and 58: 57 SPECIAL EDUCATION MEDIATION REQU
Page 59 and 60: DUE PROCESS HEARING REQUEST FORM TE
Page 61 and 62: 61 INTRODUCTION TO APPENDICES SECTI
Page 63 and 64: Physical Therapist (PT): a licensed
Page 65 and 66: QUALITY HEALTH CARE • There are s
Page 67 and 68: 67 Month: _________________________
Page 69 and 70: F Page Family Resource Center Conta

Family Information Notebook (FIN) - Vanderbilt Kennedy Center

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