Date : __________________  
  Re : ______________  
  DOB : ______________  
     
 

To Whom It may Concern:

  
  This is a letter for our patient __________________________ who has ____________  
  Congenital Adrenal Hyperplasia.  
  ____________________________ is currently taking ______________________ at the dosage of

____________________________________.		  
 
In case of illness, the dosage of _______________________________ should be adjusted as follows:		  
 

1) For low-grade fever of 101 F to 102 F, double the daily dose.
2) For high-grade fever of greater than 102 F, triple the daily dose. Give an antipyretic
(i.e. Tylenol, Advil, etc) to lower the body temperature.
3) If patient is unable to tolerate the oral administration of ________________________ because of
vomiting, contact us through the emergency beeper indicated below and be prepared to administer
Solucortef ____________ mg intramuscular injection.
4) In case of severe illness, unconsciousness or trauma, Solucortef _____________ mg intramuscular
injection should be given immediately and patient should be promptly evaluated by a pediatric
endocrinologist. Contact us through the emergency beeper.
Our pediatric endocrine service has a 24-hour emergency beeper, __________________________.

  
  If you have any questions, please feel free to call me at ________________________.
  
 
Sincerely,