Get the free INFANT HIP SCREENING REFERRAL FORM (V4.3 30/8/18

Copies to be made: 1. Sent. 2. Babies Notes. 3. ParentsNeonatal Unit London Road Reading RG1 5ANINFANT HIP SCREENING REFERRAL FORM (V4.3 30/8/18) INFANTS SURNAME:MOTHERS NAME:INFANTS NAME:MATERNITY

How to fill out infant hip screening referral

How to fill out infant hip screening referral

1. Step 1: Obtain the infant hip screening referral form from a healthcare provider.
2. Step 2: Fill out the top section of the form with the infant's personal information, including name, date of birth, and contact information.
3. Step 3: Provide information on the reason for the referral, such as family history of hip problems or physical examination findings that suggest the need for further evaluation.
4. Step 4: Include any relevant medical history of the infant, including previous hip conditions or surgeries.
5. Step 5: Provide the name and contact information of the referring healthcare provider.
6. Step 6: Sign and date the referral form.
7. Step 7: Submit the completed referral form to the appropriate healthcare facility or specialist for further assessment and management.

Who needs infant hip screening referral?

1. Infants who have risk factors for hip dysplasia or developmental dysplasia of the hip may need an infant hip screening referral. These risk factors may include:
2. - Family history of hip problems
3. - Breech presentation during pregnancy
4. - Foot deformities
5. - Torticollis (twisted neck)
6. - History of hip conditions or surgeries in the family
7. - Certain medical conditions like cerebral palsy or Down syndrome
8. It is important to consult with a healthcare provider to determine if an infant hip screening referral is necessary for a particular child.

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