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Adult transition starts at 12 years.
Transition is the process of getting ready to leave your pediatric doctors and get your health care from doctors who are trained to care for adults. Transfer of care to an adult care provider occurs around 18-19 years.
Please read the transition policy Adolescent Transition Policy (PDF)
When should you begin to discuss transition to adult care with your child?
- We recommend beginning to talk to your child at 12 years old so that they can begin to prepare.
When does transition begin?
- He/she will begin transferring to an adult doctor and to an adult medical care facility at 18 or 19 years.
What do I need to know when my child turns 19?
Your child becomes an adult in the healthcare setting in Alabama. Your child is no longer a minor.
Your child has the right and responsibility to make his/her own legal choices.
How will this change your role?
- After your child turns 19, the doctor should talk to your child about his/her health
- Every time you sign into clinic, your child will sign the hospital privacy statement. The Children’s of Alabama privacy policy allows you (parents/guardians) to learn your medical issues unless your child specifically tells us not to tell you about his medical issues.
- Your child should make decisions for his/her own health care. We still want you to help make decisions.
Some questions to ask your doctor during transition:
Level 1: Ages 12-14
- When does my child need to learn about transitioning to adult care?
- What does my child need in order to prepare for transitioning?
- When should my child learn about privacy and consent regarding his/her healthcare needs and decisions?
Level II: Ages 15-17
- If my child needs help making healthcare decisions, who/where can I get this information?
- When should we begin verifying insurance coverage?
- At what age should we begin searching for an adult health care physician?
Level III: Ages 18-19
- Are there any healthcare concerns that may prevent my child from transitioning at age 19?
- When should we request a transfer/release of medical records?
- When should we review and discuss policies/procedures for scheduling and cancelling appointments with a new physician
- Will my child need proof of school/class enrollment to maintain eligibility status for transitioning?
Some questions to talk to your child about during transition:
Below are some questions that you should think about and discuss with your parents and sickle cell medical team. These questions have been developed specifically for patients with sickle cell disease. Development of a sickle cell disease readiness for transition assessment.
Health Care Knowledge
- I understand what behaviors can cause a pain episode
- I can answer my doctor’s questions during my clinic visits.
- I keep track of my own medical appointments
- I know how to take my medicines (time, dose, how often) without help
- I am aware of what hydroxyurea is and how it affects sickle cell disease
- I understand how drugs, alcohol, and tobacco usage affect sickle cell disease
Independent Living Skills
- I know how to manage money and pay a bill
- I know how to write a check
- I know how to use an ATM card
- I have held a full or part time job
- I know how to get my prescriptions filled
- I know how to make my own medical appointments
- I go to my medical appointments on my own
- I can arrange transportation to my medical appointments
Education and Vocational Planning
- I have a vision for my future
- I plan to attain education (college or job training) after high school
- I know the types of work situations that could cause problems related to sickle cell disease
- I have talked to my parents or family about my hopes for the future
Social Support Skills
- I participate in activities at school and/or outside the home
- I have friends that I can talk to about sickle cell disease
- I have a good social support system
- I understand what healthy relationships are
Look for ways to get involved in activities and support groups from the Sickle Cell Foundation and Children’s of Alabama.
- You and your family are not alone.
Being a part of your sickle cell community is a vital part of transitioning to adulthood. Here are some informational links to find a Sickle Cell Foundation near you:
Birmingham Sickle Cell Foundation
North Alabama Sickle Cell Foundation, INC
Southeast Alabama Sickle Cell Association
Sickle Cell Foundation of Mobile
Sickle Cell Foundation of the River Region
- A Transition Program designed with specific classes to help you and your child take charge of your life after pediatrics is available at Children’s Harbor Family Center (located at Children’s of Alabama.)
- You are encouraged to attend and complete the free transition classes by the time you are 18.
Learn about the medical coverage rules:
- The rules of medical care coverage for all third party payors (including Medicaid) change by the time a child becomes a young adult.
- We will try to help you find an adult doctor, in order to prevent a lapse in medical coverage and care.
- Beginning now, start thinking about where your child may go for adult care and who might be his/her primary doctor and/or hematologists.










