Forms & Resources.
First Time Clinic Visit – Consent Form
If this is your first time visiting Associate Pediatrics Clinic, please download and complete the standard Consent Form. The document can be completed electronically and emailed back to us at firstname.lastname@example.org or you can print it out, complete it and bring it with you to your first appointment.
Virtual Care/ Electronic Communication Consent Form.
We now have the availability to communicate with our patients & families using a secure email service called Medeo. Please download the consent form in order to sign up for this service.
We have provided a list of resources sorted by category below. Simply click on the topic of interest and click to download PDF files or to visit other online resources. If you can't find a specific resource, please contact the Associate Pediatrics Clinic.
Has your child’s teacher or caregiver raised concerns over their attention and focus? Are they falling behind in school? It could be Attention-deficit/hyperactivity disorder (ADHD).
ADHD is the most common neurobehavioral disorder of childhood and can profoundly affect the academic achievement, well-being, and social interactions of children. To help us accurately evaluate if this diagnosis fits for your child, we will ask for parents and teachers to fill out rating scales on the website below. As other issues may be present as well, we may also ask for other assessments to be done; such as a learning assessment from a psychologist, hearing test, vision test and possibly a mental health assessment.
Evidence shows that a combination of behavioural strategies and stimulant medication is the most effective treatment for ADHD.
Instructions to fill out the ADHD rating scale:
- Head to www.childmentalhealth.ca
- Click on “Get Started” under the “Rating Scales” heading
- Click on “I am completing a Scale”
- Click on “ASSOCIATE PEDIATRICS“… it’s on page #3
- all the doctors in our clinic share one account so do not look for an individual name
- Click on “SNAP-V-26”
- Identify who you are (Mother, Father, Teacher, Self [the patient themselves], etc..) and fill out the patient’s demographic information
- The first box is “Comments”. Please fill in your observations of behavior issues and academic challenges in this space
- Once finished, hit “Submit” and the the scale will be automatically sent to our office
- Family & Community Resource Centre (Alberta Children’s Hospital Online Library, ADHD page) –
- ADHD Families – CanLearn Society (Excellent organization in Calgary)
- CADDAC (Centre for ADHD Awareness, Canada)
- CADDRA (Canadian ADHD Resource Alliance)
- CHADD (Children and Adults with Attention Deficit Hyperactivity Disorder)
- Main website:
- chadd.org (please create a link)
- Resources for Parents:
- chadd.org/for-parents/overview/ (please create a link)
- Main website:
- ADHD information from the National Institute of Mental Health –
- ADHD Information – Provides Practical tips
- (Ask your web browser to translate the page from French to English if needed)
- ACH Family & Community Resource Centre, Information Prescription on Autism: http://fcrc.albertahealthservices.ca/health-information/library/information-prescriptions/asd/
- Children’s Link, Autism Resources: www.childrenslink.ca
- Autism Calgary: www.autismcalgary.com
- Autism Society Foundation: autismcanada.org
- Autism Society Central Alberta: www.autismsocietyalberta.org
- Society for Treatment of Autism: www.autism.ca
- Autism Society Alberta: www.autismsocietyalberta.org
- Autism Aspergers Friendship Society of Calgary: www.aafscalgary.com
- Between Friends Club: www.betweenfriends.ab.ca
- The Ability Hub from Sinneave Foundation (For teens): sinneavefoundation.org
Autism Financial Supports
- Family Support for Children with Disabilities: https://yycpediatrics.com/wp-content/uploads/2018/06/Government-Support-Programs-FSCD.pdf
- Disability Tax Credit: https://yycpediatrics.com/wp-content/uploads/2021/04/Government-Support-Programs-DTC-Apr-9th.pdf
- Registered Disability Saving Program: https://yycpediatrics.com/wp-content/uploads/2021/04/Government-Support-Programs-RDSP-Apr-9th.pdf
- Action Plan
- Inhaler Technique
- ICAN WEBSITE
After direct trauma to the head, your child may have been diagnosed with a concussion. This can certainly be a scary experience as a parent, and it is very important to know when to seek further medical help, and how to minimize any long-term effects:
Children can suffer from various types of headaches, including migraine. It is important to recognize the possible triggers, and know what steps can be taken to help with your child’s discomfort. Your pediatrician may ask you to keep a “Journal” (see below), to help give us a better idea of the frequency and further details around these events.
- HEADACHES – AHS Document
- Headache Journal: http://www.headaches.org/headache-diary-keeping-a-diary-can-help-your-doctor-help-you/
There are some general pediatric topics that we have picked out, and have outlined some useful resources for this.
- Community Supports
- YWCA Family Resource Network – It is a collaborative group of community-based service providers offering prevention and early intervention services and supports for families with young children and teens
- Head Shape
- Pill Swallowing
- Vaccines & Advice: https://wwwnc.cdc.gov/travel & http://www.who.int/ith/en/ & http://odysseytravelclinic.com/
- Car Seat: https://www.albertahealthservices.ca/injprev/page4842.aspx
- Screen Time
- Sexual Health & Puberty
- Emergency Contraception
- Sexual Orientation
- Family and Community Resource Center (FCRC): Sexuality Resources http://fcrc.albertahealthservices.ca/health-information/library/information-prescriptions/sexuality/
- Calgary Sexual Health Center – General Information – Calgary Sexual Health Centre https://www.calgarysexualhealth.ca/sexual-health-info/sexual-orientation/
- Calgary Sexual Health Center – Counseling services https://www.calgarysexualhealth.ca/programs-workshops/counselling/
- Calgary Outlink – http://www.calgaryoutlink.ca/ Group For Youth Program http://www.calgaryoutlink.ca/inside-out Peer Support Line calgaryoutlink.ca/outisok/
- Resource List calgaryoutlink.ca/lgbtq-resource-book/
- Youthsafe – a guide to Alberta’s Resources for LGBTQ Youth http://www.youthsafe.net/
- Camp Fyrefly – http://www.fyrefly.ualberta.ca/ – Canada’s only national leadership retreat for lesbian, gay, bisexual, transidentified, two-spirited, intersexed, queer, questioning, and allied youth.
- Get Support – Kids Help Phone: https://kidshelpphone.ca/
- LGBTQ2S+ – Kids Help Phone: https://kidshelpphone.ca/topic/identity/lgbtq2s/
- Mosaic Youth Group: a peer facilitated group for LGBTQ youth, as well as queer friendly allies, ages 10 to 25. As a branch from the Miscellaneous Youth Network, this group is also a provider of safe spaces for youth involving fun activities and education into their community. As a youth group run specifically by youth. Wednesday evening from 7 – 10 pmin the Common Room of the Old Y Building (223 12 Ave SW) 403-282-0127
- PLAG https://pflagcanada.ca/
- Youthline LGBT Peer support – by phone, text, chat or email http://www.youthline.ca/get-support/ways-we-support/
- Gender Diversity Resource Guide for Youth
- Child and Adolescent Gender Services – LGBTQ+ Resources
HEAL (Health Education and Learning) is a resource aimed at providing families across Alberta easily accessible, reliable information about common minor illness and injuries in children. The content provided in the HEAL program comes directly from the Pediatric Emergency Medicine experts at the Alberta Children’s Hospital and Stollery Children’s Hospital.
Click here to find general information about the causes, symptoms and home management options for common minor illnesses and injuries, and when to seek medical care.
- croup, cough and wheeze,
- common cold, ear pain, head injury,
- vomiting and diarrhea, fever, febrile seizures,
- rashes and influenza
Another great resource for common illnesses is from Caring for Kids, a website from the Canadian Pediatric Society.
- Chickenpox, Colds, Dehydration and diarrhea,
- Ear infections, Febrile seizures, Feverand temperature taking,
- Fifth disease, Giardia, HPV, Hand, foot and mouth disease,
- Head lice, Hepatitis A, Hepatitis B, Impetigo,
- Influenza, Lyme disease, Measles,
- Meningococcal disease, Molluscum contagiosum, Mumps,
- Whooping cough, Pinkeye, Pinworms, Pneumococcal infections,
- RSV, Ringworm, Roseola, Rotavirus, Scabies, Strep throat,
- Thrush and Urinary tract infections
Feel like your child is always getting sick? Check out this great handout from the Canadian Pediatric Society about how illnesses are spread, what you can do to help your child through the illness, and what to do to help prevent catching them.
- Addiction Resources
We will often suggest the involvement of some allied health specialists to assist in your child’s development, treatment, or general health surveillance. We have provided some local contacts to help navigate “where to go”.
- Speech & Language Pathology (SLP)
- Public SLP Preschool kids (0-5 yrs) 403-955-1300
- Public SLP School age kids-resources are through the school
- Private SLP (any age): https://asapp.ca/
- Calgary Youth Physiotherapy: http://calgaryyouthphysio.com/
- Occupational Therapists:
- Food Guide
- Activity Guide & Resources
- Vitamins (D, Calcium, Iron)
- Vegetarian, Vegan
- Picky Eating