Once a patient is identified as a candidate for the NEBULA Program, our team will help create an appointment for you to meet our team in a clinic visit. During this clinic visit, patients will meet with the General Surgery, Gastroenterology and Urology teams. In addition, we have a wide range of specialists – from physical therapy to psychology – who may also be involved in your child’s care.  

Following the evaluation, our team will determine if your child needs additional imaging, testing or procedures, and create a timeline for these if needed. We will meet with you and your child to create long-term goals.  

Follow-up visits will be determined at the completion of your child’s visit and evaluations may occur every 2-12 months.     

Before your visit  

All patients referred to the NEBULA program are reviewed by our team for candidacy to our program. Preparation for your clinic visit starts weeks to months in advance.   

You will be asked to complete questionnaires and surveys regarding your child’s bowel and bladder health.   

Patients are scheduled for multiple appointments in one day to decrease the need for many trips to CHOP. This helps reduce caregivers’ and patients’ need to request time off from work and school, and the frustration associated with coordinating multiple appointments.   

After scheduling your child’s visit, details will be sent to your MyCHOP account. If you need a MyCHOP access code, please contact your NEBULA team to request one. Your NEBULA coordinator will send a detailed message to you within a few weeks of your child’s visit. The team encourages families to check their MyCHOP account often to stay up to date regarding their child’s plan of care.  

Our team offers two appointment times. You will spend most of your day consulting with all the specialists scheduled.   

If our team has asked you to complete bowel, bladder, and/or void volume diaries for your child, please submit these before their visit. You can share this information by taking a picture of the diaries using your phone (screenshot), attaching the picture to a MyCHOP message, and sending the message to our NEBULA inbox.   

If you are traveling to CHOP from a distance, please review the accommodation options available to you. See our places to stay.  

Because accurate diagnosis and treatment is essential to your child’s care, we may order additional testing to be completed before or during your visit. A NEBULA coordinator and scheduler will help you arrange necessary testing before and/or during your child’s appointment.  

Day of visit  

If possible, try to schedule your child’s NEBULA appointment for a day you can bring another adult with you. It helps keep your child occupied, and it’s helpful for two sets of ears to hear the same information. If you can, please make childcare arrangements for your other children.  

Appointments in the NEBULA Program are designed to allow visits with multiple specialists in one location. In some cases, testing can also be completed on the day of your appointment. Each specialty will meet you on the 9th floor of the Buerger Center for Advanced Pediatric Care, where the appointment will be held.

Dress your child in comfortable, layered clothing, that can easily be removed for examination by a healthcare provider upon parental/guardian consent; or layers that can be put on due to the temperature of the building.  

Plan extra time for parking and checking in. We suggest parking in the Buerger Center parking lot. After parking, take the elevator to level 1/lobby, where you will check in and present your photo ID. Bring your parking ticket with you for validation.  

After checking in on the 1st floor, take the elevator to the 9th floor and go to POD C. Our receptionists will ask for your insurance card(s) if it is your first time visiting the hospital. The receptionist will also update your demographic information if needed.   

You will complete the check-in process for each specialist. You do not need to go to another floor. All providers will see you on the 9th floor.  

You will meet our medical assistants, who will obtain your child’s height, weight and vital signs. You will accompany your child the whole time.  

You’ll be escorted to a private exam room with your child. Your time will be spent consulting with all the specialists scheduled during your visit.    

After your visit  

The day of your child’s visit is busy and filled with a lot of information sharing. When the clinic visit is complete, your providers will discuss your child’s plan of care as a team.  

You will receive a letter titled “After Visit Summary” within one week of your child’s visit. This letter includes the findings and recommendations from each specialist.  

A coordinator will contact you after your child’s visit. They will help you schedule any recommended testing and referrals to other specialists, if needed.  

A coordinator will assist you with other needs, including letters of medical necessity, medication orders, durable medical equipment and homecare orders, and clarification of instructions as needed.