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I. Referral Information. Section I is to be completed by the MIP Provider. Fax to Early On PublicAwareness: 15176680446. This form may also be emailed to: eoreferral@edzone.net.MIHP Staff Making Referral:Date:Phone:Fax:Email:Parent/Guardian
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How to fill out maternal infant health program

01
To fill out the Maternal Infant Health Program (MIHP) application, follow these steps:
02
Obtain the MIHP application form from your local healthcare provider or download it from their website.
03
Provide your personal information, such as your name, address, date of birth, and contact details.
04
Answer the questions related to your pregnancy, including the expected due date, any complications, or medical conditions.
05
Provide information about your previous pregnancies, if applicable.
06
Include details about your prenatal care provider and any current health coverage.
07
If you have any specific concerns or needs during pregnancy, it's important to write them down accurately.
08
Review the completed application form for any errors or missing information.
09
Sign and date the application form.
10
Submit the application to your local healthcare provider or the designated MIHP office.
11
Wait for confirmation or further instructions from the MIHP program regarding your enrollment.

Who needs maternal infant health program?

01
The Maternal Infant Health Program (MIHP) is designed for the following individuals:
02
- Pregnant women who are eligible for Medicaid or have limited income
03
- Infants born with medical needs or at high risk
04
- Mothers who have recently given birth and need support in postpartum care
05
- Families with infants facing health challenges or developmental concerns
06
- Parents or caregivers who require education and assistance in providing optimal care for their infants
07
- Families experiencing social or economic challenges that may affect maternal and infant health
08
If you or someone you know falls under any of these categories, they may benefit from the services provided by the MIHP program.

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The Maternal Infant Health Program (MIHP) is a program designed to improve health outcomes for pregnant women, new mothers, and infants by providing healthcare services, education, and support.
Providers and healthcare agencies who offer services under the MIHP are required to file the program's documentation and reports to ensure compliance and track outcomes.
To fill out the MIHP, providers must complete prescribed forms that include patient information, services provided, and health outcomes. It typically involves gathering data from medical records and patient interactions.
The purpose of the MIHP is to reduce maternal and infant morbidity and mortality rates by providing enhanced health services and support, thereby promoting healthier pregnancies and better early life outcomes.
Information that must be reported includes patient demographics, services rendered, health outcomes, and any referrals made to additional services.
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