Get the free Request for Maternal-Fetal Medicine Services - ohsu
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Este formulario se utiliza para solicitar servicios de medicina materno-fetal en OHSU, incluyendo información sobre la atención obstétrica de alto riesgo, ultrasonidos, y consultas con consejeros
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How to fill out request for maternal-fetal medicine
How to fill out Request for Maternal-Fetal Medicine Services
01
Obtain the Request for Maternal-Fetal Medicine Services form from your healthcare provider or hospital website.
02
Fill out patient information including full name, date of birth, and contact details.
03
Include relevant medical history, including previous pregnancies and any known complications.
04
Specify the reason for the referral, detailing any specific concerns or conditions.
05
List current medications and any allergies.
06
Provide information about the referring provider, including their name and contact information.
07
Sign and date the form to authorize the request.
08
Submit the completed form to the appropriate maternal-fetal medicine department or physician.
Who needs Request for Maternal-Fetal Medicine Services?
01
Pregnant individuals with high-risk pregnancies.
02
Patients with a history of pregnancy complications.
03
Women over the age of 35 at the time of pregnancy.
04
Individuals with underlying health conditions that could impact pregnancy.
05
Those expecting multiples (twins, triplets, etc.).
06
Women with a family history of genetic disorders.
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Why would someone go to a maternal-fetal medicine?
You may be referred to an MFM if your ob-gyn suspects that: Your baby is likely to be born before 37 weeks gestation. Your baby isn't growing well (fetal growth restriction). Your baby may have a congenital disability.
Why would you be referred to the fetal medicine unit?
You could also be referred to us if there is any concern about the growth of the baby, the fluid around the baby during your pregnancy, or if a screening test shows you are at an increased chance of having a baby with a chromosomal or genetic condition.
What qualifies you for MFM?
After completing medical school and a residency in obstetrics and gynecology, aspiring MFM specialists will spend an additional two to three years as a fellow studying maternal-fetal medicine. This extra training is what distinguishes OB-GYN providers from MFM specialists.
Why did my OB refer me to maternal-fetal medicine?
You may be referred to a maternal-fetal medicine specialist if you have a pre-existing medical condition prior to pregnancy, develop a medical condition during pregnancy or have problems during delivery. Additionally, you will see a maternal-fetal medicine specialist during pregnancy if your baby has an anomaly.
Why do you get referred to maternal-fetal medicine?
You may be referred to a maternal-fetal medicine specialist if you have a pre-existing medical condition prior to pregnancy, develop a medical condition during pregnancy or have problems during delivery. Additionally, you will see a maternal-fetal medicine specialist during pregnancy if your baby has an anomaly.
What is the difference between an OB GYN and a MFM?
The first appointment is a consultation appointment which includes an ultrasound assessment of your pregnancy. Your MFM physician will review any medical records, surgical history, medications or environmental exposures, and prenatal labs or screening tests that may have been done.
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What is Request for Maternal-Fetal Medicine Services?
A Request for Maternal-Fetal Medicine Services is a formal application submitted by healthcare providers to seek specialized care or consultation for pregnant patients with high-risk conditions that may affect maternal or fetal health.
Who is required to file Request for Maternal-Fetal Medicine Services?
Healthcare providers such as obstetricians, family physicians, or other medical professionals involved in the care of pregnant patients are required to file a Request for Maternal-Fetal Medicine Services when specialized care from a maternal-fetal medicine specialist is needed.
How to fill out Request for Maternal-Fetal Medicine Services?
To fill out a Request for Maternal-Fetal Medicine Services, providers should complete the designated form with patient information, medical history, specific concerns, and reason for referral. It is important to ensure all required fields are filled in accurately.
What is the purpose of Request for Maternal-Fetal Medicine Services?
The purpose of the Request for Maternal-Fetal Medicine Services is to facilitate the referral process for high-risk pregnancies, ensuring that patients receive the necessary specialized care and expertise to improve maternal and fetal outcomes.
What information must be reported on Request for Maternal-Fetal Medicine Services?
The Request for Maternal-Fetal Medicine Services must report information such as patient demographics, medical history, current pregnancy details, specific issues or complications, and any relevant test results that will assist the maternal-fetal medicine specialist.
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