Use of Worksheets
During a properly conducted well-child visit, a wide range of medical and social issues need to be addressed. A sample worksheet has been provided to obtain the child and family medical and social history at the first visit for a child of any age. Following this, there are worksheets that are specific for each age group.
These worksheets help to ensure that you remember to address issues in the history, physical examination, and social development that are specific to the age group. Many pediatric practices use similar worksheets.
You are encouraged to print and use these checklists during actual patient encounters.
Print Version of Child and Family Medical and Social History Worksheet
Print Version of Infant Health Maintenance (Birth to 12 Months) Worksheet
Print Version of Preschool Child Health Maintenance (12 Months to 4 years) Worksheet
Print Version of School Age Child Health Maintenance (5 to 12 years) Worksheet
Print Version of Developmental Milestones
Check off organ systems as you examine them and document any abnormal findings. Make a note of any of those systems you are unable to examine, e.g. ear canals that were occluded with wax, or if child was crying loudly and you could not hear the heart sounds. Use the worksheet to present your findings to your preceptor.
Links on each worksheet will take you to additional information about many words and concepts. We recommend that you spend some time exploring each checklist before you examine your first patient.
For patient confidentiality, be sure you shred any temporary documents after you no longer need them.
