To the Editor:

I enjoyed the article “Implementing Preventive Care Flow Sheets” [February 2001, page 51] but would like to point out an error in the flow sheet for children from birth to 12 years old. The check boxes in the health guidelines section are all shaded, implying a particular service is not indicated. Certainly we would all agree that nutrition, dental health, physical activity, fluoride, etc., are indicated for patients in at least some of this age range.

Author's response:

We train our physicians to use the health guidelines section of the flow sheet as a checklist of items for patient education as they see appropriate, particularly at well-maintenance visits. The boxes are shaded to imply that there is no specific time at which the items are indicated, so they should be handled at the physician's discretion. I encourage those who find the shading confusing to adapt the form as they see fit.