Patient Forms

For our patient’s convenience, the NF Clinical Program has made patient forms available on this web site. These forms are a necessary requirement for an appointment.

Please take time to look over this important patient information and complete the appropriate forms before your upcoming appointment at our St. Louis Children’s Hospital office location.

If you have questions, please email us at nfclinic@wustl.eduor call the Washington University NF Center Clinical Care office at (314) 454-6120.
Monday – Friday, 9 am to 5 pm (CST).

 

 

 

New Patient Letter

 Patients receive this letter prior to their appointment at the NF Clinical Program office located at St. Louis Children’s Hospital, St. Louis, Missouri.

NF Patient Screening Form
Age 0-to-36 mos

 Parents or guardians are asked to complete an age-appropriate questionnaire to help the NF Clinical Care Team identify their child’s areas of concern. This form is for children from birth to three years of age. It should be completed prior to the child’s first visit.

NF Patient Screening Form
School Age

 Patients, or parents/guardians of the patient, are asked to complete this questionnaire for school-age children to help the NF Clinical Care Team identify areas of concern. This form is for children over the age of three years old. It should be completed prior to the child’s first visit.
All About My NF (2011)
Notebook		 The NF Clinical Program has developed a NF diary for patients or their families to record information on birth history, important medical data, physician visits, surgeries, a list of testing with dates, and a brief family history.
My NF Team (2011)
Notebook		 With so many people involved in caring for a child or adult with NF, it is easy to become overwhelmed. The goal of the My NF Team notebook is to help organize your personal goals and aspirations or that of your child, and to provide an invaluable resource to facilitate communication between you and your child’s doctors, nurses, teachers, and therapists.

Your Privacy Matters – HIPAA Brochure

 This brochure explains your rights regarding the protection and privacy of your health information.