Tools for Coordinating Care: Sample Forms and Additional Resources
This section provides tools to assist in the coordination of care at the practice, community, and state level.

The Care Coordination Process: Questions and Answers | Family Involvement | Assessment| Plans of Care/Implementation/Evaluation | Resources | Advocacy | Funding www.medhomeportal.org/about/aboutCare.cfm

How to Make Best Use of Resource Information Questions and Topics
In a well child visit, here are a list of questions and topics providers should be asking families to assess if they have any needs with home health, durable medical equipment, day care, respite, insurance/financing, school, etc. Utilize local/state resource guides for information to offer families and patients. For local and state specific resources you can go to your state page "Family Corner" by clicking here.

Documentation Guidelines and Sample Forms

• Patient Visit Forms
• Medical Summary/Child History
• Sample Letters and Forms
• Practice Policy and Procedures

Tools for Enhancing Care Coordination Adobe PDF
The Physician's Guide to Caring for Children with Disabilities and Chronic Conditions, edited by Drs. Robert E. Nickel and Larry W. Desch, provides valuable tools and information on the complexities of providing comprehensive care coordination for children with special health care needs (CSHCN).

These tools include Coordination of Care Summaries, which should prove valuable in facilitating collaborative communication among the family, the primary care physician and the sub specialists:

• Situational Stressors and Family Risks Assessment
• Effect of Child's Disability on Family Members Interview
• Family and Physician Management Plan Summary for Children and Adolescents with Cerebral Palsy
• Family and Physician Management Plan Summary for Children and Adolescents with Meningomyelocele
• Family and Physician Management Plan Summary for Children and Adolescents with Cleft Lip and Palate
• Family and Physician Management Plan Summary for Children and Adolescents with Seizure Disorder
• Family and Physician Management Plan Summary for Children and Adolescents with Traumatic Brain Injury
• Family and Physician Management Plan Summary for Children and Adolescents with Down Syndrome
• Family and Physician Management Plan Summary for Children and Adolescents with Developmental Delay or Mental Retardation
• Medication Record
• Primary Care Family Assessment
• Craniofacial Disorders Psychosocial Screening Form
• Seizure Record

Last updated July 28, 2006