Ambulatory Scripts: Well Child

Standard one-liner > 2 yo	____ yo M/F Hx ____ here for WCE, and c/o ____
Birth history < 2 yo or if applicable (dev. Delay, growth, etc)	____ mo/day old M/F born at ____ via ____ Pregnancy un/complicated (by____) Delivery un/complicated (by____) Neonatal period significant for ____ PHQ-2
Significant histories & meds
Recent illness & meds (if significant)
Parents concerns today	Parents have concerns/questions about ______ No concerns about: Dev., social, growth, behavior, sleep, diet
Growth	If < 5 yo -> tracking at ___% for weight/height/etc If > 5 yo -> BMI abnormal growth
Development	Meeting milestones per interview M-CHAT (18 & 24mo)
Vitals	Within normal range vs abnormals
Physical exam	Abnormals head to toe Pertinent findings for hx, recent illness or c/o
Development exam	Meeting milestones per exam
Assessment	_____ yo well M/F with/out abnormal findings Assessment of concerns
Plan	Immunizations Screenings and other prev med per periodicity table Metabolic, fluoride, HH, lead, etc Anticipatory guidance: car/home safety, dev., diet, etc Reach Out and Read given/demonstrated f/u for next WCE Plan for specific concerns, including f/u