FOLLOW UP FORMAT
FOR ALL THOSE PARENTS WHO ARE TAKING TREATMENT FROM DR KONDEKAR FOR NEUROLOGICAL ISSUES, FOLLOWING IS THE FORMAT OF FOLLOW UP .
THE MORE ADDITIONAL INFORMATION YOU GIVE WILL BE MROE HELPFUL.
Format for giving information or follow up of your kid across whatsapp
Name of child
Date of birth
City
Payment date and time and mode
LAST CONSULTATION DATE:
TODAYS DATE:
See weekly symptom monitoring diary at http://bit.ly/monitoringautism
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WRITE YES , NO, BETTER OR WORSE BY HOW MANY PERCENT APPROXIMATE, ORT 0 TO 5, 5 IS BEST
List changes as per-- Comparing now with two week back.. and send me pl, BY WHATSAPP TO 9869405747
1. Eye to eye connection--
2.Concentration-
3-Obeying commands-
4.Response to sounds -
5. Unnecessary Jumping or running -
6.Biting mouthing throwing hitting hurting :
7.Sleep-
8.Constipation-
9.pointing, gripping, imitation, Writing -
10.Sounds from mouth-
11.Speech-
12. Pretend play, role play, Comprehension and stories listening skills, sequential
13. Other (sensory issues/ school issues/behaviours)-
14. Mixing with peers in sitting games, group work
List as gains and goals, rather than writing positives or negatives
List any medicine doses changed recently.
List any medicine couldn't be taken with number of days couldn't be taken. Read more at www.autismmumbai.com. payments to 9869405747 only
ALSO SPECIFY ANY OR MANY FO THE ISSUES BELOW:
15. Does your child Keep on walking/running? Jumping/climbing?
16. Hitting / hurting? Rolls on floor?
17. Cries all the day? Shouts /screams?
18. Potty is hard/ NOT daily?
19. Scared/ feared?
20. Puts hand on ear or angle vision?
21. Stubborn for gains? Or.Wanting something?
22.Scared? Anxiety? Constipation? Which one is maximum?
23. often in a day these issues happening?
These details will help me plan medicine titration