How to Give A Good History

When your Child has Fainting Spells

Questions you should answer before the office visit.

1. How old is the child?

2. What was the child doing during the fainting spell?                                                   

3. How many times has the fainting spell occurred?                               

4. Were there other symptoms (i.e. seizures, palpitation) prior to the fainting spell?

5. How long did the fainting spell lasts?                                                                                                                                                                             

6. Is there any recent history of head injury? Was there head injury during the fainting spell?                                  

7. Is there a history of fever, seizures, anemia or other illness in the child?                                          

8. Does the child have any previous heart surgery or seizure disorder?                  

9. Is the child taking medications?                                                                                  

10. Is there a family history of sudden death in or heart disease at young age?    

Please print this page and answer it before the office visit.