Medical and Emergency Forms for Children With Special Needs
General Medical | Emergency Medical | Additional Resources
General Medical Forms
To assist physicians and caregivers of children with specialized health care needs, the staff of the Center for Infants and Children with Special Needs at Cincinnati Children's Hospital Medical Center provides the forms below.
You can download the forms below in portable document format (.pdf). You must have Adobe Acrobat" Reader installed on your computer to read pdf files.
You can download Adobe Acrobat" Reader at Adobe's Web site by selecting the version appropriate for your type of computer.
Some forms can also be downloaded from Microsoft Word. The Word version will allow you to type information directly on the form and then save it to your computer. To open the Word version, you must have Microsoft Word 2003 or later.
In addition, The National Initiative for Children's Healthcare Quality (NICHQ), sponsored by the American Academy of Pediatrics (AAP), provides an online toolkit for parents and primary care practioners for use in the assessment and treatment of ADHD.
The information you provide will assist us in assessing your child's needs.
These forms are not to be used for self-diagnosis and are best used in conjunction with a health care provider.
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Emergency Medical Forms
In preparation for a medical emergency, it is recommended that the following completed forms be provided to the utility and Emergency Medical Service (EMS) companies providing services to the family.
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Aditional Resources
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If your questions are not fully answered by our Special Needs Resource Directory and its links, please contact us via email.
Rev. 7/08
