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Medical Information Form

Condensed Medical Information Template for encouraging independence and self-advocacy when transitioning into adulthood and from pediatric to adult CF clinic.

This medical template was created by an Omaha mother of a teenage boy with CF who could not find a condensed medical form unique enough to fit his needs. He was moving out on his own and soon would need to have this important information close at hand. It is designed to be used as a tool/guide for transitioning from pediatric to adult CF clinic.


We hope that families will find this template useful before, during, and after transition.


You will find two versions below:


  • a standard, directly printable PDF version:


  • a fillable PDF version to download, complete and then print


This Nebraska CF Families website and the NE CF Family Advisory Board are operated by local CF families with the guidance of the Omaha Children’s Hospital Cystic Fibrosis Center.  No advice or recommendations on this page should be taken above that of your CF Care Team.  Always check with your provider regarding any medical information and recommendations.  The advice and suggestions on this website are shared with the goal of helping local CF families feel connected and informed.

©2023 by NE Regional CF Center Family Advisory Board. Proudly created with Wix.com

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