Get the free Neonatal Follow-Up Clinic Referral Form - bcwomens

Neonatal Followup Clinic Referral Form BC Women's Hospital and BC Children's Hospital K3184 4480 Oak Street V6H 3V4 Telephone: (604) 8752854 Fax: (604) 8752483 Referring Hospital Patient Information

How to fill out neonatal follow-up clinic referral

How to fill out neonatal follow-up clinic referral:

1. Obtain the referral form from the neonatal follow-up clinic or hospital.
2. Fill out the patient's information accurately, including name, date of birth, medical record number, and contact information.
3. Provide the referring physician's details, including name, clinic or hospital name, and contact information.
4. Specify the reason for referral, including the baby's medical history, any existing conditions, and the need for follow-up care.
5. Indicate any specific tests or evaluations that need to be done during the follow-up visit.
6. Include any relevant medical records or reports that may support the need for a neonatal follow-up clinic referral.
7. Sign and date the referral form, ensuring that all information is legible and complete.

Who needs neonatal follow-up clinic referral:

1. Babies who were born prematurely and require specialized monitoring and care to ensure healthy development.
2. Infants who experienced complications during birth, such as asphyxia or birth injuries, and require ongoing medical evaluation and intervention.
3. Newborns who have documented conditions or syndromes that require expert management and follow-up care.
4. Babies who were admitted to the neonatal intensive care unit (NICU) and need close monitoring and assessment.

Note: It is important to consult with the baby's primary care physician or neonatologist to determine the necessity of a neonatal follow-up clinic referral and to ensure appropriate coordination of care.

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What is neonatal follow-up clinic referral?

Neonatal follow-up clinic referral is a process in which newborns, especially those at higher risk for developmental issues, are referred to a specialized clinic for monitoring and assessment of their growth and developmental milestones.

Who is required to file neonatal follow-up clinic referral?

Healthcare providers, such as pediatricians or neonatologists, are typically required to file neonatal follow-up clinic referrals for infants who have specific medical conditions or risk factors that necessitate further evaluation.

How to fill out neonatal follow-up clinic referral?

To fill out a neonatal follow-up clinic referral, the healthcare provider should provide the newborn's demographic information, medical history, pertinent findings from the neonatal period, and any specific concerns or issues that need to be addressed during the follow-up.

What is the purpose of neonatal follow-up clinic referral?

The purpose of neonatal follow-up clinic referral is to ensure that infants who may be at risk for developmental delays or health concerns receive appropriate monitoring and support to promote their growth and development.

What information must be reported on neonatal follow-up clinic referral?

Information that must be reported on a neonatal follow-up clinic referral includes the infant's name, date of birth, medical history, reasons for referral, any previous evaluations, and specific concerns related to development or health.