About the Acquired Autonomic Dysfunction Program

What is autonomic dysfunction?

Autonomic dysfunction (also called dysautonomia) is a condition in which the autonomic nervous system (ANS) isn’t working properly. The ANS controls the “automatic” functions in the body, including breathing, heart rate, blood pressure, digestion and body temperature. The condition can cause dysregulation of vital organ systems and greatly impact a child’s ability to function.

Patients we treat

The Acquired Autonomic Dysfunction Program (AADP) sees new patients younger than 18 years of age. We treat patients diagnosed with autonomic dysfunction, including but not limited to postural orthostatic tachycardia syndrome (POTS). This program will be inclusive of (replace) the existing POTS Program and will provide an even broader range of services and expertise to these complex patients.

Requirements for participation in the program, to support care coordination:

• Behavioral health evaluation and consultation with General Pediatrics
• Use of MyCHOP, our secure online patient portal, for communication with care team. To set up your MyCHOP account request a MyCHOP access code online or call us at 267-426-0030.

To participate in our program all new patients require one-hour consultations with our our care-coordination provider and a behavioral health specialist, in addition to other subspecialists as needed. You will have the opportunity to connect with a social worker regarding any school issues, referrals and/or resources available in the community. You may also be asked to meet with a physical therapist to assist with an individualized exercise regimen.

Help us get to know your child

Prior to scheduling your first appointment, we will ask for a copy of your child’s medical records and for you to complete an intake form. This information will help us determine the appropriateness of evaluation in our center.

Once we receive all required information, we will contact you to discuss scheduling an appointment.

Step 1

Complete our online intake form here. 

Step 2

Submit the following information by email to AADPrecords@email.chop.edu or fax 215-590-3198.

1. Download our New Patient Intake Form here. When it is completed, send it to AADPrecords@email.chop.edu. After you fill out the form, please remember to save a copy to your computer and to submit your personalized version.
2. A medical summary or clinical summary from the referring primary care provider or specialist. If the referring provider is at CHOP, you do not need to provide this summary.
3. A copy of the front and back of your insurance card (if new patient to CHOP).
4. Medical records from outside institutions, including medical tests radiology reports and laboratory reports that pertain to the reason for your child’s visit can be faxed to 215-590-3198 or emailed to AADPrecords@email.chop.edu.
5. Please fill out our AADP HIPAA form and send it to AADPrecords@email.chop.edu.

Please note that we will not be able to discuss scheduling any appointments until we receive all the information above.