Formularios para el Nuevo Paciente de Desarollo y/o Neurología

Si su nino (a) tiene 3 anos o es menor, complete los siguientes formularios:

Si su nino (a) tiene 4 anos, complete los siguieñtes formularios:

Si su nino (a) es 5 anos o mayor, complete los siguientes formularios:

Instrucciones para citas en persona: Por favor imprima una copia del siguiente formulario, completelo y traigalo a la proxima cita.

Instrucciones para citas de telemedicina: Por favor enviar una copia del formulario completo en format PDF al siguiente correo electronico (CSHHIMSMedRecRequests@rwjbh.org)

Lamentablemente, no podemos acceder al formato de imagen ni a las fotos de los documentos del teléfono móvil

Ademas, si su hijo/a tiene 12 años o mas, complete el siguiente formulario:

Patient Stories

  • “I’ve helped my buddy go from swimming with a noodle to swimming by themselves and it’s a really great feeling to be able to make some sort of difference on a child’s life and help them be able to swim,” remarked Emma.

    Emma
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  • “I love that the team incorporates whatever Kruz is interested in and makes it therapeutic. He loves balls, so they do a lot of catching and throwing to help him get more range of motion. They also play with a lot of bubbles which he loves.”

    Kruz
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  • “Not every child is the same, especially with down syndrome, and CSH was great at communicating where his strengths were, where his weaknesses were and what we should continue doing.”

    Sebastian
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Patient Stories

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