Chilld/Teen Follow Up!

Child/Teen Follow-Up Form (c) 

** We suggest saving a copy of the Follow-Up form for your records and bringing a copy to your scheduled in-person visit. 

We suggest a treatment journal for each child/teen who presents to the SMart Center for treatment.
Directions on creating a journal!
All follow-up forms, goals/games given after each appointment can be kept in this journal and then brough to each appointment.

Submit the version of choice below via:
Email:   Subject: Child/Teen FU form
(You can send as attachment or copy/paste into body of email)
Fax:  215-827-5722
Mail: SMart Center ~ 505 Old York Road ~ Jenkintown, PA 19046






                 MS Word format 

                      PDF format 
If you do not have Adobe Acrobat to read a PDF file click the button below to download it now:  



SM Child/Teen Follow Up Form (C) Dr. Elisa Shipon-Blum and SMart Center
All users must abide by copyright laws.
Reproduction Permissible