Late Effects Survey submitted by ZoAnn Dreyer for Texas Children's Cancer Center at Baylor College of Medicine

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*1. How does your institution provide follow-up care for childhood cancer survivors?
Answer:(1)Followed in regular ONCOLOGY CLINIC by pediatric oncology healthcare provider (MD/NP/PA)
*2. What is the age cut-off for providing follow-up care to childhood cancer survivors at your institution?
Answer: (1)No age limitation - followed for life
*3. Please provide phone numbers (as applicable) for referral of long term follow-up patients to your Institution.
(If not available, enter "None"):
Appointments: Answer:832-822-4240
General information: Answer:832-822-4200
New LFTU patient referrals: Answer:832-822-4728
Comments: Answer:832-822-4727 coordinator
*4. If your institution does not provide life-long follow-up care for childhood cancer survivors, please describe where the patient is referred for long term follow-up when age limitation is reached:
Answer: (1)Adult oncologist
If your institution has a specialized long-term follow-up program for childhood cancer survivors, please complete the following information:
5. Program name: Answer:Texas Children's Cancer Center Survivor Clinic
6. Program director: Answer:ZoAnn Dreyer, MD
7a. Program coordinator: Answer:Sarah Bottomley, RN, MN, CPNP
7b. Program coordinator:  Answer:Gaye Hamor-Coordinator
*8. What are the eligibility criteria for survivors entering your program?
Answer: 2 years off therapy
5 years from diagnosis
Bone marrow transplant patients are eligible
Neuro-oncology patients are eligible
*9. Do you offer late effects consultations to survivors who were not treated at your institution?
Answer: Yes
*10. What information is required for a patient being referred from an outside facility to your program?
Answer: Health care provider referral letter
Medical Records
Insurance information
Patient may self-refer into the program
Other eligility criteria

Health care provider referral preferred, however may self refer. If no insurance we do assess for other funding sources.

11. If your institution has a specialized adult follow-up program, please provide the following information:
Program name: Not Answered
Program director: Not Answered
Program coordinator: Not Answered
*12. Who provides the long-term follow-up care for your adult survivors of childhood cancer?
Answer: Pediatric Oncologist
Pediatric Nurse Practitioner
As above we plan to add a FNP to assist with the young adult/adult population.
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