Neonates Questionaire – Kids Health Space

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Specialist Team
Allied Health Team
Medical Conditions
Behavioural Conditions
Appointments
Journal
Contact Us

Neonates Questionaire

Child's Firstname*
Child's Lastname*
What is your child's age?*
Do you have any concerns?*
Please describe if you have any concerns
Pregnancy
How was your Antenatal Scans?*
Please describe the Antenatal Scan issues*
How was your Blood pressure?*
Please describe your issues with Blood pressure*
Did you have Gestational Diabetes during pregnancy?*
Please describe your diet or Insulin management*
What was your Vitamin D level?*
What was your Iron Level?*
Birth History
Birth term*
Delivery*
Hospital*
Were there any complications during birth?*
Birth weight (in kgs)*
Baby checkup at the hospital*
What issues were reported during the baby checkup at the hospital?*
Feeding*
Did the child have any vomitting?*
Did the child have explosive stools?*
Family History
Number of children in the family*
Please enter a number from 1 to 20.
Any significant medical conditions?*
Any parental court orders or ongoing legal issues?*
Any Hip issues in the family?*
Any Kidney issues in the family?*
Any Milk / Lactose allergies?*
Any regular medications / Allergies?*
Any surgeries / past medical conditions?*
Immunisation*

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Campbelltown Centre:

Suite 6 & 7,
82-84 Queen Street,
Campbelltown
NSW 2560

Oran Park Centre:

TRN house,
Level 1 Suite 1.07,
90 Podium Way
Oran park
NSW 2570

Appointments available
Monday - Friday

Campbelltown Centre:

info@kidshealthspace.com.au

Oran Park Centre:

oranpark@kidshealthspace.com.au

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