Doctor intake form

TT and I were up bright and early this morning to head out the door around 6:30 in order to be at a Psychiatrist appointment down at the children's hospital. The reason I made this appointment was in the hope that I could get a prescription for something to help her sleep when she goes on her anxiety-based no sleep binges. We would all be just a little happier. I might have mentioned before about being nervous about meeting and breaking in new doctors, and the appointment today just confirmed my trepidation in general. The extremely short story is that I am 99.9% sure that we will not be keeping the second intake appointment that would be required for us to get any help from this direction.

This appointment, like so many others, required the completion of a very lengthy intake form. (Forget the fact that all of the specialists we see are in the same system with the results of other lengthy intake forms happily logged into the system. I assume they are logged in. Maybe I fill them out and they are tossed in the trash. Who knows? Yes, I'm feeling snide and snarky. Brace yourselves.) I thought how terribly useful it would be if I could pre-screen any potential doctor who has contact with my child ahead of time. That way, I could weed out the ones who clearly will not be suitable for us and save myself the 3+ hours of driving, the hour of appointment, and the $11 parking garage fee. It would just be so much simpler. (Actually, if someone would actually create a "physician-approved-mother" badge that would show the rest of the medical establishment that I am 1. not a imbecile and 2. not prone to unhelpful panicking, that would be beyond amazing. We could all start off on good footing right off the bat.)

So, as therapy for myself, I have decided to create such an intake form, even if I never get to use it. And yes, be my guest and infer what this morning's appointment was like to your heart's content.

New Doctor Intake Form

Please complete the attached form to help us make a better judgement as to how well you fit with our family's care.

Control
1. I need to stick to a previously determined routine in meeting patients regardless of why the patient is there.
Always □   Sometimes □  Seldom □  Never  □

2. I believe the doctor is the most important and educated person in the room.
Always □   Sometimes □  Seldom □  Never  □

3. I believe that after two hour-long meetings with the parent and very little interaction with the child, I will be able to make a comprehensive plan as to how to help them.
Always □   Sometimes □  Seldom □  Never  □

4. I believe that my time is far more valuable than my patient's, so I will not read the patient's file before the first meeting.
Always □   Sometimes □  Seldom □  Never  □

Savior Complex
5. I am the only person who can help the patient, the parent is merely window dressing.
Always □   Sometimes □  Seldom □  Never  □

6. I believe that parents are sometimes a necessary hindrance to the treatment of a pediatric patient.
Always □   Sometimes □  Seldom □  Never  □

Biases
7. Homeschoolers should always be looked upon with suspicion.
Always □   Sometimes □  Seldom □  Never  □

8. Homeschoolers with adult children living at home should be looked at with even more suspicion.
Always □   Sometimes □  Seldom □  Never  □

9. I believe that parents of large families are largely uneducated.
Always □   Sometimes □  Seldom □  Never  □

10. I believe that parents with advanced degrees are to be treated with more dignity and respect than parents without advanced degrees.
Always □   Sometimes □  Seldom □  Never  □

Family Experience
11. I have worked with adopted children before.
Yes □   No□

12. I have adopted children myself.
Yes □   No□

13. I am trauma informed and realize that some discipline methods are not helpful for children affected by trauma. (i.e. timeouts, punishments, etc.)
Yes □   No□

14. I realize that adopted children most likely do not have biological family medical history no matter how many times I ask and how much I would like to have it.
Yes □   No□

Thank you for your cooperation. We will be getting back to you. Due to heavily booked schedules, response times can take several months. If there is a cancellation at a inconvenient time of day, we will notify you.

Comments

Molly said…
OH MY GOODNESS YES!!! I would love to have this form to take with me! I can't tell you how many times I have to remind them I have like zero information about her prior to the age of 2. How was her birth? Good question! Does she have family history of this? I have no idea!
GRRRRR.

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