Intake Follow-Up Form
Welcome back to the UCSF Division of Pediatric Surgery Faculty
Practice. Our goal is to provide a comprehensive follow-up
evaluation of your child's surgical problem. During your visit, we
will review the medical history, perform a physical exam, and
review your child's x-rays. Depending on the complexity of your
child's problem, anticipate your visit may last several hours.
Your answers here will become part of your UCSF medical record
and will be confidential. This is a secure form and any
information you provide will be handled in strict compliance with
applicable privacy laws.