DBP Forms and Manuals

DBP Forms and Manuals

There are a number of DBP forms that will be useful during the rotation. In addition, there are information manuals that describe the policies, procedures, and processes of specific DBP Clinics at LPCH.

Clinic Forms

Form / Use / Inclusion in Learning Portfolio?
Direct Observation Checklist / Give this form to DBP Clinic attendings to complete after they have observed your interactions with clinic families and patients. / At least one completed and signed form should be uploaded into your DBP Learning Portfolio.
Social Communication and Developmental Skills Record / Use this form to structure your observations of clinic patients (when you are observing psychological testing, speech/ language assessments, etc.). Complete the Social Communication section and the Developmental Skills section. / At least two completed forms should be uploaded into your DBP Learning Portfolio.
Guide to Preschool Observation / Use this form to guide your observations at Bing Preschool and HeadStart Preschool. / Two completed forms (one for each preschool observation) should be uploaded into your DBP Learning Portfolio.
Preschool Reflection / Use this form to reflect on your preschool observations. Identify any lessons that you learned during the observations and discuss how this new knowledge might be used in your clinical practice. / One completed form should be uploaded into your DBP Learning Portfolio.
Tutorial Reflection (Behavior Management) / Use this form to reflect on behavior management strategies. Describe a context or case during which you addressed these strategies. / One completed form should be uploaded into your DBP Learning Portfolio.
Resident self-evaluation form / Complete this form at the end of the rotation. Discuss with DBP attending during end-of-rotation review. / One completed form should be uploaded into your DBP Learning Portfolio.

Information Manuals

Manual for DBP Developmental Consult Clinic and DBP Autism Clinic (ver3 062409)

Manual for DBP High Risk Infant Follow-up Clinic (ver4 062409)

Dictation Forms

Please review the Guidelines for DBP Dictations. Several examples of DBP dictations are provided as models for your own dictations (Examples - DBP Dictations).

Form / Use / Inclusion in Learning Portfolio?
Dictation Form – Autism Clinic / Use this form when reviewing patient charts before Autism Clinic.* Fill in any sections with information from available parent forms in patient chart. Bring form to Autism Clinic and complete after seeing patient. Use completed form to structure dictation. / Not included.
Dictation Form – HRIF Clinic / Use this form when reviewing patient charts before HRIF Clinic.* Fill in any sections with information from available parent forms in patient chart. Bring form to HRIF Clinic and complete after seeing patient. Use completed form to structure dictation. / Not included.
Dictation Form – Developmental Consult Clinic / Use this form when reviewing patient charts before Developmental Consult Clinic.* Fill in any sections with information from available parent forms in patient chart. Bring form to Developmental Consult Clinic and complete after seeing patient. Use completed form to structure dictation. / Not included.

* Go to DBP Offices (750 Welch Road, Suite 212) to review patient charts before clinics.