Physician Resources – Charting Templates 11 years to 17 years

There must be a way to make practice easier…

A note from Dr. Erika,

Adolescent well visits can be some of the most complex encounters in primary care. Balancing parent concerns, confidential screening, mental health, risky behaviors, puberty changes, and social pressures—all in one appointment—can feel overwhelming.

These charting templates were created to make that process easier. Using AAP guidelines and naturopathic best practices, I built structured templates that guide the entire visit and prompt essential discussions on sexuality, safety, mental health, social media, and developing independence.

I’m delighted to share them with you.

Note: Because adolescent visits require significantly more content, this set is nearly the double the length of earlier Charting Templates and Well Child Guides. 

$69.00

This product is designed for Naturopathic Physicians, Primary Care Providers or other healthcare providers only. It is not intended for personal or patient use.  

Included in Physician Resources – Charting Templates 11 years to 17 years

  • Subjective, Objective, Assessment (with ICD-10 codes) and Plan templates for ages 11, 12, 13, 14, 15, 16 and 17 years.
  • The Subjective section includes questions to ask parents, including safety checks, school performance, bullying, disordered eating, sudden cardiac death screening, screen use and more. Confidential subjective information for ages 13-17 includes guided questions on substance use, sexual health/safety, bullying, suicide prevention and more. These questions help the provider ask the teen about sensitive topics in an open, approachable format.
  • The Objective section includes sample templates for “normal” findings for all body systems at each age group.
  • The Assessment section includes ICD-10 codes appropriate for each time frame (for normal findings).
  • The Plan section includes a template for providing naturopathic guidance for each time frame.  This includes topics for each age group, including guidance about pubertal development, acne, teenage brain development, social media use, safety online, sexual identity/development, topics around dating/consent, STI/pregnancy prevention, and more.  This section also includes subjects to discuss with both the parent/teen, as well as an optional confidential discussion without the parent present. This section also includes information about how to support parents through specific developmental stages, including parenting tips and understanding normal behaviors at specific ages.

Well Child Guides

Also included are the Well Child / Well Teen Guides ages 11 years, 12 years, 13 years, 14 years, 15 years, 16 years and 17 years.  Use these as handouts for your practice for each well adolescent check.  Note: these teen-focused well child guides are nearly double the length of the earlier childhood guides, as each handout includes information for both the parent and teen.

These guides are very thorough in scope and depth around risky teenage behaviors, including sexuality, substance use, online/social media, bullying and more.  The handouts discuss some highly sensitive topics in a conversational format that is appropriate for families with a wide range of personal, cultural, and religious values about sexuality. They are also packed with evidence-based parenting tips to reduce risky behaviors and improve the mental health of teenagers.

Included in every Well Child / Well Teen Guide is an Herb Guide! Each Herb Guide includes detailed information on use, safety and dosage* for a herb that Dr. Krumbeck deems to be age-appropriate.  Patients love them!

Included in the 11 Year Well Child Guide

  • Normal behaviors at 11: increasing independence, peer pressure, early mood swings.
  • When to be concerned: red flags for eating disorders, mental health concerns, self-harm, bullying and more.
  • Parent tips for talking about puberty, encouraging independence, positive reinforcement.
  • Guidance on adequate nutrition, screen time, sleep.
  • 2 page guide for the 11-year-old child: “Snooze like a champ: your guide to awesome sleep.”
  • Herb guide: Peppermint: a fantastic herb used for a number of digestive conditions, tension headaches and muscle pain.*

Included in the 12 Year Well Child Guide

  • Normal development: continued pubertal development, menarche for girls, acne, normal growth, behavior and mood challenges at age 12, new romantic attraction, normal brain development in pre-teens.
  • When to be concerned: signs of fatigue, mental health issues, signs of self-harm, body image issues and more.
  • Parenting tips for pre-teens, including conversation starters, tips for talking about puberty, and supporting independence paired with responsibility.
  • A discussion of media and online safety, preventing abuse, teaching your preteen the dangers of social media and unfiltered internet access.
  • Guide for 12-year preteens: 4 pages for the child, including “what’s normal,” when to talk to a doctor/trusted adult, and a thorough discussion of internet/media safety, including hidden online dangers, privacy, cyberbullying, protecting digital reputation, security, gaming, and preventing abuse.
  • Herb guide: Gotu kola: a fantastic stress-relieving, anti-inflammatory, connective-tissue supportive herb.*

Included in the 13 Year Well Child Guide

  • Common behaviors, worries, emotions, and normal continued pubertal development.
  • When to be concerned: signs of eating disorders, mental health concerns, bullying, lack of puberty, academic issues, behavior problems.
  • Parenting tips for 13-year-olds, including conversation starters, encouraging independence, talking to your teen about risky behaviors, creating a family agreement, evidence-based tools to prevent substance use, and discussing sexuality with teens.
  • Information about nutrition, sleep, and skin care.
  • Guide for 13-year-olds: 4 pages discussing substance use/abuse, exploring new feelings and relationships, a guide to words/terms/labels about sexuality/sexual health, consent and sexual activity, avoiding sexting, where to find accurate information about sexual health.
  • Herb guide:  Chaste tree berry (Vitex agnus-castus): a fantastic herb that can be helpful for PMS, irregular menses, hormonal headaches, mood swings.*

Included in the 14 Year Well Child Guide

  • Common behaviors at this age, including increase in appetite, new romantic interests, concern with appearance, mood swings, sarcasm, testing limits or negotiating rules.
  • When to be concerned: mental health concerns, bullying, lack of puberty, academic issues, signs of self-harm, behavior problems and more.
  • Parenting tips for 14-year-olds, including how to navigate these stronger opinions and teens who test limits.  Other tips include conversation starters, evidence-based ideas for talking to teens about risky behaviors, sexual development, and abuse prevention.
  • Information on how to support the foundations of health: nutrition, exercise, hygiene, meal-timing, and limiting screens.
  • Guide for 14-year-olds: 4 pages discussing stress/mood/emotions, acne and skin care, safe dating and healthy relationships, technology and online safety, risks of drugs/alcohol/vaping, bullying prevention and more.
  • Herb guide: California poppy (Eschscholzia californica): a gentle, non-habit-forming sedative herb to support sleep, reduce anxiety and calm the nervous system.

Included in the 15 Year Well Child Guide

  • Normal development, including continued physical changes, brain development, and common behavioral changes.
  • When to be concerned: signs of eating disorders, mental health concerns, bullying, lack of puberty, academic issues, behavior problems, decline in hygiene, use of substances, and more.
  • Parenting tips, including promoting goal-setting, encouraging independence, conversation starters, communication regarding sexual health and safety, encouraging academic success, guidance regarding driving and real-world safety.
  • How to support the mental health & emotional well-being of teens, screening for anxiety and depression.
  • Guide for 15-year-olds: 4 pages discussing sexual health & safety, including a guide into emotional readiness with any sexual activity, a lengthy conversation around consent (and lack of consent), healthy/unhealthy relationships, pregnancy basics, birth control, STIs and STI prevention. This guide is neutral in tone, and discusses with the teen that some 15-year-olds may not be ready for any physical activity, and some may already be sexually active.  It is written in a way that should feel supportive for all families regardless of the cultural or religious beliefs around sexuality.
  • Herb guide: Lavender, a classic anxiolytic herb, also used to support digestive function, reduce pain, and support healing for mild skin irritations.

Included in the 16 Year Well Child Guide

  • Normal development, including physical changes, cognitive and academic development, explorations of identity, emotional changes, romantic interests, and peer pressure.
  • When to be concerned: mental health concerns, bullying, behavior issues, academic problems, hygiene issues, use of substances, and more.
  • Parenting tips, including how to promote independence while maintaining boundaries, conversation starters, tips for talking about substance use in teens, supporting mental health and more.
  • A parent guide to discussing relationships/dating and sexual activity in teens, and how to develop healthy relationships, including a conversation about consent.
  • Guide for 16-year-olds: 4 pages discussing substance use/abuse, including dangers of alcohol, cannabis, vaping, fentanyl, “pill parties,” methamphetamine, inhalants, and more.  The 16-year guide also includes a section on driving safety, developing a family “code-word,” online safety and protecting the digital  reputation of teens.
  • Herb guide: St. John’s Wort, a fantastic mood stabilizing herb, often used for PMS/PMDD and depressive symptoms in teens.*

Included in the 17 Year Well Child Guide

  • Guidance for parenting teens approaching adulthood – how to stay involved, encourage responsibility, setting boundaries and more.
  • Tips for preparing teens for more independence – cooking, healthcare independence, planning for life after high-school, budgeting and bank accounts, chores and more.
  • When to be concerned: mental health concerns, academic problems, substance use, behavior problems and more.
  • Parenting tips: conflict resolution, conversation starters, driving safety, family values, letting go, protecting their digital footprint and more.
  • Guide for teens: “Your last well-child appointment,” which includes information on how teens can take responsibility for their own healthcare needs, including gathering medical records, understanding healthcare access, the importance of wellness visits, prioritizing healthy habits and mental health, and more.
  • Herb guide: Ashwagandha, a well-known adaptogenic herb, helpful for stress and hormonal balance.*

*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease. This information is provided for informational purposes only and is not medical advice.  

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