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EARLY PREGNANCY ASSESSMENT CLINIC REFERRAL (EPIC) Jim Patti son Outpatient Care and Surgery Center×NUNS* NUAS107008ANov. 29/17Page: 1 of 1JPOCSC Maternity Clinics 9750 140th Street, Surrey, BC Phone:
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To fill out the NUAS107008A Early Pregnancy Assessment form, follow these steps:
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Start by providing your personal information such as your name, date of birth, and contact details.
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Specify the date of the assessment and the healthcare provider conducting the assessment.
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Answer the questions related to your current pregnancy, such as the missed menstrual period date, any additional symptoms or complications, and the duration of pregnancy.
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Provide details about your medical history, including any previous pregnancies, medical conditions, or surgeries.
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Indicate the results of any laboratory tests or ultrasound examinations that have been conducted.
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If applicable, include information about any medications or supplements you are currently taking.
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Answer the questionnaire regarding your emotional well-being and any support you may need during the pregnancy.
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Note: It is always recommended to consult with a healthcare professional for guidance on filling out the form accurately and completely.

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It ensures comprehensive and personalized care during the early stages of pregnancy by providing a standardized format for collecting relevant data.
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Both the pregnant individuals and their healthcare providers benefit from the information recorded on this form, as it aids in proper assessment and decision-making regarding prenatal care.
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Nuas107008aearly pregnancy ass is a form used to report an early pregnancy assessment.
Pregnant individuals or healthcare providers are required to file nuas107008aearly pregnancy ass.
Nuas107008aearly pregnancy ass should be filled out with relevant information about the pregnancy assessment.
The purpose of nuas107008aearly pregnancy ass is to document and track early pregnancy assessments.
Information such as the date of assessment, findings, and recommendations must be reported on nuas107008aearly pregnancy ass.
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