Nemours Children's Clinic, Philadelphia Patient Appointment Form
Nemours Children's Clinic, Philadelphia Patient Appointment Form
Nemours Children's Clinic, Philadelphia Patient Appointment Form
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Write down any questions you have about your child’s diagnosis. Items printed below may help you think of what you<br />
want to discuss during your visit with our <strong>Nemours</strong> team.<br />
My current concerns are:<br />
New medications for my child:<br />
My child has experienced these new symptoms:<br />
Are there other symptoms that I should be looking for?<br />
Please write down any additional questions you have for our <strong>Nemours</strong> team during your child’s visit.<br />
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Advanced pediatric specialty care, here in your community.<br />
What is the next step in treating my child?<br />
What else can I do at home to help my child?<br />
Are there any activities or foods my child should avoid?<br />
Ask the name of the diagnosis/condition.<br />
Learn more at <strong>Nemours</strong>’ www.kidshealth.org. Information on our award-winning<br />
site is reviewed by our <strong>Nemours</strong> physicians specifically for parents, teens and kids.<br />
<strong>Nemours</strong> Children’s <strong>Clinic</strong>, <strong>Philadelphia</strong><br />
©2010. The <strong>Nemours</strong> Foundation. <strong>Nemours</strong> is a registered trademark of the <strong>Nemours</strong> Foundation.
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