Patient Resources

Patient Forms

• Adult Health History Form 
• Patient Information Form - English 

Patient Education

• LiVe it Up: Fitness and Health for Children & Teens (by Dr. Mark Templeman, MD) 

Web Resources

• 2-1-1 Information and Referral 
• Intermountain Healthcare Health Resources by Topic 
• IntermountainLiVE.org 
• My Health 
• Symptom Checker 

Patient Education

• Asthma: Breathing Easier booklet 
• Asthma: Breathing Easier booklet - How to Use a Nebulizer 
• Asthma: Breathing Easier booklet - Symptoms and Triggers 
• Asthma: Breathing Easier booklet -How to Use a Press and Breathe 

Patient Education

• ADHD Attention Deficit Hyperactivity Disorder handout 
• ADHD Attention Deficit Hyperactivity Disorder handout Spanish 

Web Resources

• Angel's Hands Foundation 
• Children with Special Health Care Needs 
• Disabled Children's Relief Fund 
• DSPD (Division of Services for People with Disabilities) 
• Family to Family Network 
• National Dissemination Center for Children with Disabilities (NICHCY) 
• Utah Family Voices 
• Utah Medical Home Portal 
• Utah Parent Center 
• Utah Parent Center Training 

Web Resources

• Billing & Financial Assistance 
• CHIP: Children's Health Insurance Program 
• Disabled Children's Relief Fund 
• NeedyMeds 
• Patient Access Network (PAN)  
• Patient Advocate Foundation 
• Patient Services, Inc. 
• Social Security: Apply for Children's Disability Benefits 
• United Healthcare Children's Foundation  
• Utah Medicaid 

Patient Forms

• Adult Baseline Evaluation Packet 
• Adult Follow-up Evaluation Packet 
• Child/Adolescent Baseline Evaluation Packet 
• Child/Adolescent Follow-up Evaluation Packet 
• School Baseline Evaluation Packet 
• School Follow-up Evaluation Packet 

Patient Education

• Depression handout 

Web Resources

• Allies with Families 
• NAMI Utah (National Alliance on Mental Illness)  

Patient Education

• Improving Your Experience: Intermountain Personalized Primary Care 
• Personalized Primary Care at Hillcrest Pediatrics 

Web Resources

• Personalized Primary Care