Handouts and Forms
CHDResources.org
supporting those with heart defects

Copyright 2002-2008 California Heart Connection
Please let us know if you find these handouts and forms helpful.  If you have any feedback on these forms, or suggestions for additional handouts or forms, please contact us at:  1-877-8-CHD INFO (1-877-824-3463) or email us CHDResources@aol.com.  We are always looking for additional information that can help those with heart defects.
Document Name

Resource Guide
(6-page handout)






Emergency Information Sheet
(1-page form)



When to Call the
Doctor or 911
(1-page form)




Follow-up Care
(2-page form)





Physical Activity
(1-page form)



Medication Tips
(2-page form)



Medication Summaries
(2 pages each, 8 common medications)





Preparing For Your
Child's Hospital Stay
(3-page handout)



Medical Specialists
(6-page handout and form)




Internet Resources
(1-page handout)



What to Ask the
Surgeon and Hospital
(2-page handout)


What to Ask the Insurance Company and Common Insurance Terms
(4-page handout)


Description

Compiled list of information critical to those with children with CHD.  Includes information on medical issues to clarify with the physician, helpful products, Early Intervention services, insurance/financial information, and much more.  This Guide is an invaluable tool for physicians, case managers and parents of children with CHD.  


Information every parent should have available in case of emergency with space to fill in important information.  Copies can be distributed to caregivers, school administrators, and kept in the car or other areas in case of emergency.

Form to be filled out by physician which delineates which symptoms warrant a call to the doctor, or a trip to the ER.  Helps to decrease parent's anxiety trying to determine the severity of a medical issue and gives them clear instructions for specific symptoms.


Overwhelmed parents may be confused as to the many different follow-up and other appointments that are necessary.  This form allows physicians to fill in approximate timelines for future appointments, vaccinations, therapies, etc. which helps parents keep current with important medical appointments.


Form to clarify appropriate activities for the child with CHD.  Excellent tool for clarification for parents, care-givers and schools so that the patient's health is not compromised, and the child is not excluded from activities that are not dangerous.


Useful tips on administering medications properly and more easily to children and infants which is often a source of significant stress for families.


Benefits and possible side effects of many common pediatric heart medications, with fill-in area for physicians to indicate dosage information and special instructions such as what to do if a dose is missed, storage information and more.  Medication summaries courtesy of PedHeart Prints Patient Education Software, developed by Scientific Software Solutions.


Tips and suggestions for preparing for surgery help parents understand what to expect, what to bring, and questions to ask prior to a procedure or hospital stay.


Families are often confused about the function of each of the different medical specialists they come in contact with.  This form includes a description of different medical specialties and appropriate questions to ask each specialist.  Space is provided to include contact information for each for referrals.


Selected online resources for heart diagrams and information on specific diagnoses



A list of questions to help compare hospitals to aid in the patient's decision-making regarding treatment options



Important terms to better understand coverage and costs with a list of questions to ask about specific benefits, restrictions, out-of-pocket costs, etc.


Below you will find a description of each of the forms available.  All forms are downloadable for free.   Click here to view/print ALL FORMS

Note:  you will need Adobe Acrobat 8.0 - download it for free at:  www.adobe.com/products/reader/)