Free Down Syndrome Medical Checklist Template
Down Syndrome Medical Checklist
Prepared By: [YOUR NAME]
Contact: [YOUR EMAIL]
Organization: [YOUR COMPANY NAME]
Address: [YOUR COMPANY ADDRESS]
Phone Number: [YOUR COMPANY NUMBER]
Email: [YOUR COMPANY EMAIL]
Personal Information
|
Field |
Sample Data |
|---|---|
|
Full Name |
Jonatan Farrell |
|
Date of Birth |
January 1, 2050 |
|
Parent/Caregiver Contact |
Winona Harvey, winona@you.mail |
Key Medical Evaluations and Screenings
-
Annual thyroid function test
-
Cardiology evaluation (every 5 years or as advised)
-
Hearing assessment (every 6 months for children, annually for adults)
-
Vision screening (every 1–2 years)
-
Bloodwork for anemia and vitamin D levels (annually)
Developmental and Behavioral Support
-
Speech therapy assessment (as needed)
-
Occupational therapy evaluation (annually)
-
Behavioral health check-in (every 6 months)
-
Educational program review with school/caregiver (annually)
-
Social skills group participation (monthly)
Routine Health Maintenance
|
Date (Future Appointments) |
Appointment Type |
Notes |
|---|---|---|
|
February 12, 2050 |
Vision Screening |
Scheduled |
|
April 18, 2050 |
Annual Physical Exam |
Pending |
|
July 10, 2050 |
Cardiology Evaluation |
Booked |
-
Maintain a balanced diet and exercise plan
-
Track vaccinations and booster schedules
-
Update emergency medical plan annually
Call to Action
For further assistance or customizations to this checklist, contact [YOUR COMPANY NAME] at [YOUR COMPANY EMAIL] or [YOUR COMPANY NUMBER]. Empower proactive healthcare today!
