Medical History Form/Questions
I'm sending the bio parents of our children letters requesting medical history. Neither was involved in their case plan/TPR so we really have no background. Both are currently incarcerated but should be released soon. I'm not really counting on them responding to our request, but I think that it's just something we need to try.

So my question -- anyone have a good form or set of questions to ask? I've tried searching online but most of what I'm finding has more to do with the child's medical history.

Thanks in advance!
Didn't the agency give you all the medical records and social information? We have all kinds of medical records and reports for our niece...so is that not normally given?
No information given
The bio parents showed up at the case plan meeting but were not heard from otherwise throughout the case plan/TPR. I have the birth records which the agency obtained for TPR, but no real medical history. We do know there is a history of mental illness, but that's really about all we know.

That's a good question though that leads me to wonder if the agency has a form I could use?
You can make the form nicer, but here a bunch of questions I would ask.
HEENT:
Eyes problems? If yes, explain. If yes, do you wear glasses?
Hearing problems? If yes, explain. If yes, do you wear hearing aids?
Sinus problems?
Ears, nose or throat problems?

Skin:
Jaundice (yellow skin)?
Eczema?
Other dermatologic concerns?

Neck:
Any thyroid problems?

Chest:
Wheezing/asthma/bronchitis? If so, how severe?

Abdomen:
Gallbladder problems?
Intestinal problems? (diverticulitis, ulcers, Barrett's)
Liver problems? (cirrhosis, hepatitis)

Pelvis:
Age of menarche (menstrual period)?
Bladder/kidney problems?
GYN issues?
Fertility issues?

Neurologic:
Mental health history? (depression, hyperactivitiy, bipolar, suicide attempts, manic depressive, schizophrenia)
Addiction? Drugs (ask type), alcohol, drugs (ask type)/alcohol
Epilepsy/seizures?
Stroke?

Orthopedic (bone) problems?

Neuromuscular:
Any neuromuscular problems?

Cardiovascular:
Heart problems/issues?
High cholesterol/triglycerides?
High blood pressure?

Hematologic:
Anemia?
Any blood disorders?
Sickle cell?
Blood type if known?
Any known history of HIV/AIDS, hepatitis B or C (most common)...you can ask, but they may or may not answer honestly

Diabetes? If yes, age of onset?
Cancer? If yes, type?
Any other health history you would like to disclose?
Pertinent surgeries?

Allergies to food?
Allergies to medications?
Allergies to insects/environment?

Then I would type it all again and ask the same questions of family history.
You might want to add in there as well if therea are family history of cancers and diseases, not just the bio's but their family as well.
When I adopted my son one of the things they did was send me a family medical assessment before I finalized. I forget what it was called but it had a lot of information in it about the medical history of the bparents/grandparents. You might want to ask the caseworker about it. I was told it was part of the adoption process.
The papers should be included in the adoption process....should list medical history of bio parents, grandparents and siblings if known. I would call the agency and ask them if they have that type of information....
All times are GMT. The time now is 5:46 am.
TOP