Creating a Medical Profile – A Tool for Parents and Caregivers


Medical Profile FormThis profile form was developed to help parents and caregivers who need to bring a child or adult who has difficulties communicating to a hospital emergency department. This could be a person with a developmental disability, autism and/or a mental health concern.

This form was developed by the Neuropsychiatry Task Force, Women’s and Children’s Mental Health, BC Mental Health and Addictions Services. It was created in response to the concerns of many caregivers that it is very difficult to communicate complex information to medical staff effectively when the carer is coping with a distressed individual.

The intention is that this profile acts as a living document that can be adapted/expanded by the parent/ guardian by updating the form as a word document on their own computer – this means they can ensure it is current and accurate. Community professionals can help families who struggle in English to complete it so they are better prepared for an emergency visit.

Not all of it is necessary for every person – fields can be deleted completed. Additions such as photos are optional. Other information can be added. It can be adapted to use in the school or group home environment. If it is to be used for a medical environment, however, it is important that it be kept as brief as possible. In a crisis professionals will be looking for essential information.

This information will be treated as confidential by medical staff.

This form was developed by the Neuropsychiatry Task Force, Women’s and Children’s Mental Health, British Columbia Mental Health and Addictions Services. A member of the Task Force,  ACT – Autism Community Training has been tasked with the responsibility of keeping this form current. Suggestions for improvement and questions can be sent to ACT at  info@actcommunity.ca.