You can’t change the past or the present, but you can change the future.

New Patient Supporting Documents for Pediatric Adolescent Medicine


The following information pertains to patients ages 12 to 21.

Diagnosis /Symptom: Adolescent Behavioral Medicine

What should the referring provider send?

  1. Pertinent medical records

Diagnosis /Symptom: Chronic Fatigue

What should the referring provider send?

  1. Pertinent medical records
  2. Growth charts
  3. Radiographic reports
  4. Relevant laboratory studies
  5. List of all medications 

Diagnosis /Symptom: Chronic Somatic Complaints

What should the referring provider send?

  1. Pertinent medical records
  2. Growth Charts
  3. Radiologic reports
  4. Relevant laboratory studies
  5. List of all medications

Diagnosis /Symptom: Eating Disorders

What should the referring provider send?

  1. Pertinent medical records
  2. Growth Charts
  3. Relevant laboratory studies
  4. List of all medications

Diagnosis /Symptom: Adolescent Gynecology

What should the referring provider send?

  1. Pertinent medical records
  2. Growth Charts
  3. Radiographic reports
  4. Relevant laboratory studies
  5. List of all medications

Diagnosis /Symptom: Family Planning

What should the referring provider send?

  1. Pertinent medical records

Diagnosis /Symptom: Gay, Lesbian, Bisexual and Transgender, Questioning Youth/Young Adult Care (GLBTQ)

What should the referring provider send?

  1. Pertinent medical records

*Note: Younger ages accepted on a case-by-case basis.

Diagnosis /Symptom: HIV Care, Testing, and Prevention Services

What should the referring provider send?

  1. Pertinent history and physical
  2. Pertinent lab work