• Are there any concerns with the following musculoskeletal areas?
• If other, please specify
• Are there any concerns with cardiac function?
• If yes, please explain
• Is there a record of a baseline ECHO?
• If yes, at what age (in months) was the baseline ECHO?
• Scoliosis
• If yes, is scoliosis:
• Behavioral concerns
• Immunization status
• Current DMD symptoms:
• Describe other symptoms
• First presenting symptom(s):
• First concern
• If other, please specify
• Symptom onset age value
• Age at 1st symptom unit
• Approximate age at 1st symptom
• Developmental assessment done at this visit
• Standardized developmental screening tool(s) used