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High Risk Perinatal Program Newborn Intensive Care ProgramMaternal and Newborn Transport Services Policy and Procedure Manual January 2018Health and Wellness for all Arizonans Doug Ducey, Governor State

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How to fill out maternal and newborn transport

01

To fill out maternal and newborn transport, follow these steps:

02

Begin by entering the date and time of the transport.

03

Provide the full name of the mother and any medical identification numbers.

04

Specify the reason for the transport, including any medical conditions or complications.

05

Indicate the destination and mode of transportation (e.g., ambulance, helicopter).

06

Document the status of the mother and newborn at the time of transport.

07

Include any special instructions or considerations for the transport staff.

08

Obtain necessary signatures from relevant healthcare professionals.

09

Ensure that all information is accurate and legible.

10

Store the completed transport form in the appropriate medical records for future reference.

Who needs maternal and newborn transport?

01

Maternal and newborn transport is needed for pregnant women and newborn infants who require transportation

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