Pediatric Endocrinology

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.

• Sick Day Guidelines (PDF)
• What Foods Are Good For A Sore Throat (PDF)

Insulin Calculations

Please use the forms listed below to help you and your child manage his or her diabetes:

• Insulin Calculations (PDF)
• Clinic Visit Plan (PDF)

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:

• Children with Diabetes

Diabetes and Endocrine disorder advocacy groups:

• JDRF
• American Diabetes Association
• The Magic Foundation
• International Diabetes Federation

Food and nutrition information:

• Eat Right (Academy of Nutrition and Dietetics)

Resource for parents looking for information or for other doctors who specialize in Pediatric Endocrinology:

• Pediatric Endocrine Society

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