The Vascular Birthmarks Foundation
A Parent's Checklist
by Corinne Barinaga
When Contacting a Vascular Birthmark Specialist about your child, please provide them with the following information.
1. Age/D.O.B of patient
2. Was the child full term, if not how early?
5. Current weight/height
6. Location of lesion(s)
7. Describe the current shape, size, appearance
8. When did the birthmark appear?
9. How has the birthmark changed (in appearance and size) and at what rate did it change?
10. What treatment(s) to date has your child had? Please include any comprehensive information you have available (test results, dosages, laser settings, etc.)
11. List specialists your child has seen for the vascular birthmark or for other medical concerns. Please include their contact information if needed.
12. Please provide the Pediatrician’s name, address and phone number
13. Are you able to provide MRI/Ultra sound, medical records, other test results upon request?
14. Include pictures of the birthmark from birth to current, all relevant angles and if possible a size reference (i.e. ruler or coin).
15. Please describe your concerns about the vascular birthmark.
16. Please describe any health concerns.
17. Please provide detailed information on any medical issues or diagnosed problems?
18. What type of insurance, if any do you have (so doctor can provide advice on how to proceed with referrals or other required information)?
19. What are you seeking from this initial contact with the specialist (advice, second opinion, consultation with your current doctor, appointment, procedure date, etc.)?
20. What questions do you have for the doctor?
21. Remember to include all of your contact information.