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11955 DALLAS PKWY, FRISCO | M-F 8-6 SAT 9-12 SUN 2-4
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(214) 396-5200 | Phone
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(214) 504-1796 | Fax
info@pediatricpeople.com
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Locate
11955 Dallas Parkway, Frisco
Hours
M-F 8-6 | Sat 9-12 | Sun 2-4
Learn More
Accepted Insurance
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No Surprises Act
Providers
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Provider Skills Survey
Provider Skills Survey
Michael
2019-01-03T14:13:54-06:00
Provider Name:
*
Date of Completion
*
MM slash DD slash YYYY
Date of meeting scheduled with Dr Linck
MM slash DD slash YYYY
What type of patient visit do you enjoy the most?
*
What type of patient care do you feel that you are or want to be an "expert" in?
*
Obesity
Mental Health / ADHD
Asthma
Preventative Care
Diabeties
Injuries
Other
If other, explain.
*
What type of patient visit have you identified that you would like additional training in?
*
What type of patient do you enjoy but feel the need for additional CME / training to provide?
*
Are there any additional resources that you need to be able to perform your job (such as equipment, additional educational resources / textbooks / websites, CME opportunities, one-on-one trainings with another provider)?
*
Is there a particular age group of children you enjoy caring for the most?
*
Yes
No
If yes, please explain.
*
Is there a particular age group that you find most challenging (add additional information if it also includes a particular type of medical problem you feel challenged managing)?
*
What size sterile gloves do you wear?
*
6
7
8
9
10
Is there a part of your daily work-flow that is a problem for you?
*
Yes
No
If yes, please explain.
*
Is there a BluePrint that you wish we had in HealthFusion that is currently not available?
*
Yes
No
If yes, please explain.
*
Please rate your confidence in treating ASTHMA:
*
Least Confident
Somewhat Confident
Neutral
Confident
Most Confident
Please mark any items that you are requesting additional assistance /guidance in providing:
Interpreting PFT
Formulating and Asthma Action Plan
Managing an Asthma Exacerbation
Completion of Asthma paperwork for ISD
Please list any items that you enjoy providing:
Please rate your confidence in treating CONCUSSION:
*
Least Confident
Somewhat Confident
Neutral
Confident
Most Confident
Please mark any items that you are requesting additional assistance /guidance in providing:
Administering SCAT form for Concussion
Interpreting SCAT form for Concussion
Formulating Return to play following a Concussion
Providing a complete Neuro exam on a child following a Concussion
Please list any items that you enjoy providing:
Please rate your confidence in treating FOOD ALLERGY:
*
Least Confident
Somewhat Confident
Neutral
Confident
Most Confident
Please mark any items that you are requesting additional assistance /guidance in providing:
Teaching the use of epinephrine to the patient and family
How to prescribe EpiPen/Auvi-Q
Completion of FARE allergy action plan
Completion of Allergy paperwork for ISD
Please list any items that you enjoy providing:
Please rate your confidence in treating FOREIGN BODY REMOVAL:
*
Least Confident
Somewhat Confident
Neutral
Confident
Most Confident
Please mark any items that you are requesting additional assistance /guidance in providing:
Embedded Earlobe Earring removal
Removal of foreign body from the external auditory canal
Removal of Impacted Ear wax with currette
Removal of foreign body from the nose
Removal of a splinter from soft tissue
Please list any items that you enjoy providing:
Please rate your confidence in treating CIRCUMCISION:
*
Least Confident
Somewhat Confident
Neutral
Confident
Most Confident
Please mark any items that you are requesting additional assistance /guidance in providing:
Ability providing a circumcision
Which type of circumcision do you feel most adequately trained on providing (PlastiBell, Gompco, Mogen)
Please list any items that you enjoy providing:
How long of an appointment would you prefer if you want to provide this service?
Please rate your confidence in treating LACERATION REPAIR:
*
Least Confident
Somewhat Confident
Neutral
Confident
Most Confident
Please mark any items that you are requesting additional assistance /guidance in providing:
Closure of a laceration by Staple
Closure of a laceration by Glue
Closure of a laceration by Suture
Closure of a laceration by Steri Strip
Suture removal
Staple removal
Please list any items that you enjoy providing:
Please rate your confidence in treating TONGUE TIE ANKYLOGLOSSIA:
*
Least Confident
Somewhat Confident
Neutral
Confident
Most Confident
Please mark any items that you are requesting additional assistance /guidance in providing:
Frenulotomy (Tongue Tie release)
Please list any items that you enjoy providing:
Please rate your confidence in treating MANAGEMENT OF AN UMBILICAL GRANULOMA:
*
Least Confident
Somewhat Confident
Neutral
Confident
Most Confident
Please mark any items that you are requesting additional assistance /guidance in providing:
Cautery of umbilicus for an umbilical granuloma
Please list any items that you enjoy providing:
Please rate your confidence in treating MANAGEMENT OF A NURSEMAIDS ELBOW:
*
Least Confident
Somewhat Confident
Neutral
Confident
Most Confident
Please mark any items that you are requesting additional assistance /guidance in providing:
Ability to currently reduce a nursemaids elbow
Ability to identify a nursemaids elbow
Please list any items that you enjoy providing:
Please rate your confidence in treating MANAGEMENT OF A WART:
*
Least Confident
Somewhat Confident
Neutral
Confident
Most Confident
Please mark any items that you are requesting additional assistance /guidance in providing:
Cryotherapy of a wart
Cryotherapy with shaving of a callus with a plantar wart
Please list any items that you enjoy providing:
Please rate your confidence in treating MANAGEMENT OF A FRACTURE:
*
Least Confident
Somewhat Confident
Neutral
Confident
Most Confident
Please mark any items that you are requesting additional assistance /guidance in providing:
Taking an Xray of upper extremity (MD or DO only)
Taking an Xray of lower extremity (MD or DO only)
How to validate and send Xray to radiologist
How to burn a CD of an Xray for the patient
Knowledge of what type of splint is needed depending on injury
Placement of an aluminum finger splint
Placement of a posterior lower leg splint
Placement of an ulnar gutter
Placement of a thumb spica
Placement of a posterior upper arm splint
Please list any items that you enjoy providing:
Please rate your confidence in treating MANAGEMENT OF MINOR BURNS:
*
Least Confident
Somewhat Confident
Neutral
Confident
Most Confident
Please mark any items that you are requesting additional assistance /guidance in providing:
Ability to triage burns that need referral
Ability to manage simple burns
Please list any items that you enjoy providing:
Please rate your confidence in treating MENTAL HEALTH MANAGEMENT:
*
Least Confident
Somewhat Confident
Neutral
Confident
Most Confident
Please mark any items that you are requesting additional assistance /guidance in providing:
*
Ability to initially manage an ADHD/ADD patient not previously diagnosed and never on medications
Ability to initially manage an ADHD / ADD patient previously already on medications
Ability to manage an established ADHD /ADD patient already on medications
Ability to interpret Vanderbilt forms
Ability to assist in obtaining 504 / IEP
Experience managing ADHD / ADD in the past
Interest in managing ADHD / ADD patients in the future
Understanding of ADHD / ADD evaluation process at Pediatric People
Understanding of Mental Health resources at Pediatric People
Please list any items that you enjoy providing:
Please rate your confidence in treating MANAGEMENT OF INFANT JAUNDICE:
*
Least Confident
Somewhat Confident
Neutral
Confident
Most Confident
Please mark any items that you are requesting additional assistance /guidance in providing:
Comfort with utilizing bili tool to formulate care plan
Process for ordering a serum bilirubin
Interpreting transcutaneous bilirubin meter results
Process for ordering home phototherapy from Cooks Home Health
Please list any items that you enjoy providing:
Please rate your confidence in treating PREVENTATIVE CARE FOR A CHILD UNDER 2 YEARS:
*
Least Confident
Somewhat Confident
Neutral
Confident
Most Confident
Please mark any items that you are requesting additional assistance /guidance in providing:
Ability interpreting ASQ results in this age group
Ability in referral process for therapies
Ability interpreting MCHAT results
Ability interpreting SPOT results
Ability interpreting hemoglobin results
Ability interpreting lead results
Ability providing anticipatory guidance
Ability providing sleep training guidance
Ability providing nutritional guidance
Ability providing dental care guidance (dental varnish)
Please list any items that you enjoy providing:
Please rate your confidence in treating PREVENTATIVE CARE FOR A CHILD OLDER THAN 2 YEARS - 9 YEARS:
*
Least Confident
Somewhat Confident
Neutral
Confident
Most Confident
Please mark any items that you are requesting additional assistance /guidance in providing:
Ability interpreting ASQ results in this age group
Ability interpreting hearing screen / vision results
Ability interpreting lipid panel results
Ability providing anticipatory guidance
Ability providing enuresis guidance
Ability providing nutrition guidance
Ability providing toilet training guidance
Ability providing sleep training guidance
Please list any items that you enjoy providing:
Please rate your confidence in treating PREVENTATIVE CARE FOR A CHILD OLDER THAN 10 YEARS - 18 YEARS:
*
Least Confident
Somewhat Confident
Neutral
Confident
Most Confident
Please mark any items that you are requesting additional assistance /guidance in providing:
Ability interpreting PHQ results / HEADs screening
Ability providing anticipatory guidance
Ability providing nutritional guidance
Ability providing sleep training guidance
Please list any items that you enjoy providing:
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