Childen's Hospital Boston 300 Longwood Avenue
Boston, MA 02115
(617) 355-6000
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Clinical Services (Atopic Dermatitis Center):
Forms
Please fill out the following forms to help us determine if the Atopic Dermatitis Center is right for your child. Once the forms are completed and returned to us, the scheduling office will contact you.

Parent report form
Survey of behavior concerns in children with atopic dermatitis & allergies
Dermatology family impact sheet
Infant's dermatology quality of life index
Children's dermatology life quality index
Food allergy quality of life questionnaire
Family Education Sheet
Mail or fax completed forms to our clinic coordinator Jeanne Marino.

Billing information
Mailing address
Children's Hospital Boston
Atopic Dermatitis Center
300 Longwood Ave, Fegan 6
Boston, MA 02115
Attn: Jeanne Marino

Phone
617-355-6180

Fax
617-730-0310

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X The information on this website should not be taken as medical advice,
which can only be given to you by your personal health care professional.
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