The pediatric suite of TSWF AIM forms are intended to guide pediatricians and primary care providers in the management of their pediatric patients. The forms follow the American Academy of Pediatrics (AAP) Bright Futures standards. They are divided into two types: the Well-Child forms and the Peds General form. Well-child forms are labeled and separated by ages 0-23 months, 2-6 years, and 7-18 years. These forms possess the age-specific requirements needed to safely document and manage each age group. The Peds General form is intended for pediatric patients who are being seen for acute medical conditions.

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Training Material for All Users

Pediatrics Recent Changes
  • 18 changes for Sep-Dec 2019 update

Screening Tab

  • Added “Is a household family member currently deployed or on extended duty outside of the immediate area?”
  • Added “Would you like information on additional family resources that may be available during this time?”
  • Removed “Visit is deployment related [Yes] [No]”


  • Added DVPRS
  • Removed 0/10 Pain Scale

Behavioral Health Tab

  • Updated PHQ-9A to auto calculate (Move to 2020)

Screening Tab

  • Updated USPSTF recommendation regarding varnish: ‘The USPSTF recommends that primary care clinicians apply fluoride varnish to the primary teeth of all infants and children starting at the age of primary tooth eruption.’ to the Preventive Services Ribbon.
  • Added link to Flouride Varnish CSSP and location to document completed actions (Anticipatory Guidance/Flouride Varnish/Dental Referral)
  • Updated Need for prophylactic administration clinical clue
  • Added “dental topical fluoride treatment varnish”

HPI Tab, in female maturation ribbon

  • Added clinical clue: “Document pregnancy status in Screening Module”


  • Added additional pain questions under a ribbon.
  • Added second question asking how pain has been over past week
  • Added statement with Y/N response stating that treatment of condition is expected to fully resolve pain experienced at current time.
  • Added documentation of Acute vs. Chronic Pain
  • Added documentation that patient will make a follow-up appointment to address pain
  • Added clinical clue to refer to IBHC for specific situations
  • Added DVPRS to verbiage on Pain Reassessment documentation field to make sure that the DVPRS is used for pain reassessment

Sep – Dec Mid-Cycle Changes

Peds 2-6 Rev. 1

  • Added 24 & 30 month milestones
      • In use since 2012
      • Collaborative effort by each Service
      • Forms follow AAP Bright Futures standards
The Pediatric TSWF AIM forms have been in use since 2012. The forms were immediately embraced by the pediatric community and used successfully throughout the MHS en masse. With this popularity came the realization that the original content of the form needed revision. Near the end of 2013, a team of pediatricians from each Service met and worked to update and improve the forms to where they stand today. At that meeting, it was unanimously decided that the forms would follow the American Academy of Pediatrics (AAP) Bright Futures standards. In total, over 160 redundant, erroneous, and non-past medical history terms were removed. This resulted in a more standardized form that allows for the note view to have a much-improved readability. In addition, restructuring of the form’s layout has aided in improving the clinical workflow.
Form Lead

TSWF-Pediatrics Form Lead
Dr. James Neville, MD, MPH, FACPM

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