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NEONATAL HYPERBILIRUBINEMIA SEVERE (NHS) (infant 60 days or less) CANADIAN Pediatric SURVEILLANCE PROGRAM REPORTING INFORMATION (To be completed by the PSP Senior Coordinator) Report number: Month
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Provide relevant medical history, including any previous diagnosis of hyperbilirubinemia or related conditions.
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Answer all the questions pertaining to your symptoms, such as the duration and severity of jaundice, any associated pain, and any changes in urine or stool color.
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It is a form used for reporting cases of hyperbilirubinemia in newborns.
Healthcare providers and hospitals are required to file this form.
The form must be filled out with detailed information about the newborn's condition and treatment.
The purpose is to track and monitor cases of hyperbilirubinemia in newborns for public health purposes.
Information such as the newborn's bilirubin levels, treatment given, and any complications must be reported.
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