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How to use or fill out Has the child, a sibling, or a parent had a seizure; has the child had brain or other with our platform
- Click ‘Get Form’ to open it in the editor.
- Begin by entering the patient’s name and date of birth at the top of the form. This information is crucial for identifying your child’s records.
- Proceed to each question, marking 'yes', 'no', or 'don’t know' as applicable. For question 7, regarding seizures and nervous system problems, ensure you provide accurate information based on your family history.
- If you answer 'yes' to any questions, be prepared to provide additional details as prompted by your healthcare provider.
- Complete the form by signing and dating it at the bottom. Ensure all sections are filled out clearly to avoid delays in processing.
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