Children's Hospital Colorado

New Patient Supporting Documents for Rehabilitation Psychology

Diagnosis /Symptom: Concussion with symptoms persisting beyond 2 weeks

What should the referring provider send?

  1. A complete list of all medications, including psychoactive medications
  2. Medical records regarding the injury
  3. Any neuroimaging
  4. Description of concerning symptoms, history, and treatments attempted
  5. School records and special education reports
  6. Any previous psychological or psychiatric records

Diagnosis /Symptom: Behavioral or Psychological Distress in presence of Medical Diagnosis

What should the referring provider send?

  1. A complete list of all medications, including psychoactive medications
  2. Medical records regarding relevant past evaluation and treatment
  3. Reports of any relevant imaging or medical studies related to medical syndrome
  4. Description of concerning symptoms, history, and treatments attempted
  5. Reports of neuropsychological or psychological evaluations
  6. School records, including IEP, evaluations, standardized testing, or reports, as available

Diagnosis /Symptom: History of Moderate-Severe Traumatic Brain Injury or other Acquired Brain Injury

What should the referring provider send?

  1. A complete list of all medications, including psychoactive medications
  2. Medical records regarding illness or injury, past evaluation and treatment
  3. Reports of any relevant neuroimaging or medical test results
  4. Concerns reported by parent or school personnel regarding developmental stall in psychological, emotional, cognitive, academic arenas or behavior, with history of pediatric Acquired Brain Injury (TBI, anoxia, stroke, surgery, encephalitis)
  5. Description of concerning symptoms, history, and treatments attempted
  6. School records, including IEP, evaluations, standardized testing, or reports, as available