Table 12.

Example clinical care plan.

Today your child saw the following providers
Neurology (Dr. X, contact information)	Prescribes X medication (dosage and schedule) for seizures
	Prescribes X medication (dosage and schedule) for behavioral issues
	Recommends X study to be completed
Physiatry (Dr. X, contact information)	Prescribes X medication (dosage and schedule) for spasticity
Physical Therapy (X, contact information)	Recommends the following exercises and stretches
Nutrition (X, contact information)	Recommends the following changes to your child’s diet