Professional Documents
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6 to 8 Week Assessment (Gestational Age) IF THE CHILD IS MORE THAN 12 WEEKS OLD PLEASE USE AN 'UNSCHEDULED' FORM
CHT
FEEDING:-
CF
Ever breast fed (Y/N)
* Always exclusively breast fed (Y/N)
*
MCD
Current feeding (previous 24 hours) Child's age when breast feeding stopped: Weeks *Days * HBO
(B, F, M, O, U)
Development outcome of assessment: N - No Concerns C - Concern newly suspected P - Concern/Disorder previously identified X - Assessment incomplete
Tools: - indicate all used during the review to support developmental assessment (see over for codes)
Physical examination: Length (cms) Weight (kg) OFC (cms) Date measured
For each of the items below, enter N - normal, A - abnormal, D - doubtful or uncertain, I - not done/incomplete.
Future action: enter code if applicable P - Provide S - Signposted to D - Discuss with R - Request assistance from W - Refused
Parenting
Speech & Community
GP Support Audiology Language Paediatrics
CAMHS Childsmile
Smoking
Early Financial Other
Cessation CHW Education Advice Services Social Work Physio/OT Services
Summary: list any issues likely to be relevant to the child's ongoing health, development or well-being.
PLEASE PRINT CLEARLY ENTER ISSUE STATUS
Issue Status Read Code
(1)
(2)
(3)
(4)
Place of review
(enter Y for all that apply) Home Clinic GP Practice Other