Forms and Support Documents
Forms, Tools, and Supporting Materials
To make your next appointment go easier, please bring your child's blood sugar meter and any supplies that go along with it. Please also bring the following forms, or have your child's physician fax them to us:
- Diabetes Clinic Visit Form (PDF)
- Diabetes Blood Sugar Log (PDF)
- Recent lab reports
- Growth chart
- Insurance cards
Sick Day
If your child is ill, we advise you to follow the sick day guidelines that we are providing, and/or to contact our office at 312.996.1795. If you are calling after hours, please ask to page the endocrinologist on call.
Insulin Calculations
Please use the forms listed below to help you and your child manage his or her diabetes:
Forms for New Patients
- Endocrine and Diabetes Clinic Patient History (PDF)
- Clinic Visit Plan for Children Newly Diagnosed With Type 1 Diabetes (Your Child's Care Plan) (PDF)
- Diabetes Patients: "Know Your A-1C" Form (PDF)
External Information/Related Websites
Online community for children living with diabetes:
Diabetes and Endocrine disorder advocacy groups:
Food and nutrition information:
Resource for parents looking for information or for other doctors who specialize in Pediatric Endocrinology:
Specific information on:
- Diabetes, including type 1 and type 2: Diabetes Basics
- Metabolic syndrome: IDF Definition
- Growth Disorders: Growth Hormone Deficient Children
- The rare disorder known as ROHHAD: Rapid-onset obesity with hypothalamic dysregulation, hypoventilation, and automatic dysregulation