Patient Resources

Patient Forms

• Adult Health History Form 
• Allergy Medical History Form 
• Authorization to Use and Disclose Protected Health Information Form 

Web Resources

• American Academy of Pediatrics 
• Intermountain Healthcare Health Resources by Topic 
• KidsHealth 
• March of Dimes 
• My Health 
• Symptom Checker 

Patient Education

• Advance care directives 
• Advance care directives Spanish 
• Advance Care Planning booklet and advance directive forms Utah 
• Advance Care Planning booklet and advance directive forms Utah Spanish 

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 (Spanish) 
• Asthma: Breathing Easier booklet -How to Use a Press and Breathe 

Patient Forms

• Child/Adolescent Baseline Evaluation Form 
• Child/Adolescent Follow-up Evaluation Form 

Patient Education

• ADHD Attention Deficit Hyperactivity Disorder handout 
• ADHD Attention Deficit Hyperactivity Disorder handout Spanish 
• ADHD Talking to your Childs or Teens Teachers 
• ADHD Talking to your Childs or Teens Teachers Spanish 
• ADHD: Talking with Your Child 
• ADHD: Talking with Your Child Spanish 
• ADHD: Tips for Teachers 

Web Resources

• National Dissemination Center for Children and Youth with Disabilities 
• NICHCY: Learning Disabilities  
• Utah Parent Center 
• Utah Parent Center Parents as Partners in the Educational Process 

Patient Forms

• Child/Adolescent Baseline Evaluation Form 
• Child/Adolescent Follow-up Evaluation Form 

Patient Education

• Depression handout 
• Depression handout Spanish 

Web Resources

• National Alliance for the Mentally Ill (NAMI) 

Web Resources

• Child Health & Safety Information 
• National Safe Kids Campaign 

Web Resources

• BMI Calculator - Kids & Teens 
• IntermountainLiVE.org