Module 10

Module 10h: Clinic Visit

Moico Module 3 Alt
This module is completed when entering the patient registry and updated as required. Information is collected about clinics that the participant attends.
 
NoCodeQuestionResponse
11.3.1ClinicSiteRegion where clinic(s) located1 – United States of America;
2 – Other North America;
3 – South America;
4 – Europe;
5 – Asia;
6 – Africa;
7 – Oceania
11.3.2ClinicSiteUSAWhich clinic(s) in the United States of America?1 – Seattle Children’s Hospital (Seattle, Washington US);
2 – UCSF Benioff Children’s Hospital (San Francisco, California US);
3 – UCLA CART Center for Autism Research and Treatment (Los Angeles, California US);
4 – Rady Children’s Hospital San Diego (San Diego, California US) ;
5 – Intermountain Primary Children’s Medical Center (Salt Lake City, Utah US);
6 – Children’s Hospital Colorado (Aurora, Colorado US);
7 – Texas Children’s Hospital (Houston, Texas US);
8 – Mayo Clinic (Rochester, Minnesota US) ;
9 – Minnesota Epilepsy Group (St. Paul, Minnesota US);
10 – Rush University Medical Center (Chicago, Illinois US);
11 – Lurie Children’s Hospital Chicago (Chicago, Illinois US);
12 – Monroe Carell Jr. Children’s Hospital (Nashville, Tennessee US);
13 – Geisinger Autism & Developmental Medicine Institute (Lewisburg, Pennsylvania US);
14 – NYU Langone Medical Center (New York, New York US);
15 – Weill Cornell Medical College of New York (New York, New York US);
16 – Massachusetts General Hospital (Boston, Massachusetts US);
17 – UNC Carolina Institute for Developmental Disabilities (Carrboro, North Carolina US);
18 – Miami Children’s Hospital (Miami, Florida US);
19 – Other
11.3.3WhatOtherClinicUSAName and location 
11.3.23ClinicSiteNorthAmericaWhich clinic(s) in other North American countries?1 – Children’s Hospital of Eastern Ontario (Ottowa, Canada);
2 – BC Children’s Hospital;
3 Other
11.3.24WhatOtherClinicNorthAmericaName and location 
11.3.28ClinicSiteSouthAmericaWhich clinic(s) in South America?1 – Brazil Angelman Clinic;
2 – Argentina Angelman Syndrome Clinic;
3 – Other
11.3.29WhatOtherClinicSouthAmericaName and location 
11.3.33ClinicSiteEuropeWhich clinic(s) in Europe?1 – Erasmus Angelman Syndrome Center, Rotterdam, The Netherlands;
2 – St Mary’s Hospital, Manchester, UK;
3 – Edmond and Lily Safra Children’s Hospital, Sheba Tel Hashomer (Tel Aviv, Israel);
4 – Other
11.3.34WhatOtherClinicEuropeName and location 
11.3.38ClinicSiteAsiaWhich clinic(s) in Asia?1 – Edmond and Lily Safra Children’s Hospital, Sheba Tel Hashomer (Tel Aviv, Israel);
2 – Other
11.3.39WhatOtherClinicAsiaName and location 
11.3.41ClinicSiteAfricaWhich clinic(s) in Africa?1 – Edmond and Lily Safra Children’s Hospital, Sheba Tel Hashomer (Tel Aviv, Israel) ;
2 – Other
11.3.42WhatOtherClinicAfricaName and location 
11.3.45ClinicSiteOceaniaWhich clinic(s) in Oceania?1 – Melbourne Royal Children’s Hospital Clinic;
2 – Development Assessment Service, St George Hospital, Kogarah, NSW;
3 – Other
11.3.46WhatOtherClinicOceaniaName and location 

 

 

 
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