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Virginia Perinatal Hepatitis B Prevention Program Mother Information Form Case No. VEDAS#: Mother Information:Name: LastFirstMiddleSocial Security Number: / / Address: Phone #: City/County of Residence:
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How to fill out virginia perinatal hepatitis b

01
Step 1: Obtain the Virginia Perinatal Hepatitis B Form from the healthcare provider or medical facility.
02
Step 2: Fill out the patient's personal information such as name, date of birth, and contact details.
03
Step 3: Provide details of the pregnancy, including the estimated due date and any relevant medical history.
04
Step 4: Indicate the mother's hepatitis B status, including whether she is positive, negative, or unknown.
05
Step 5: If the mother is positive for hepatitis B, provide additional information about her viral load and any treatment she is receiving.
06
Step 6: Fill out information about the newborn, including date and time of birth, birth weight, and APGAR scores.
07
Step 7: Specify whether the newborn received hepatitis B immunoglobulin (HBIG) and the date and time it was administered.
08
Step 8: Document the hepatitis B vaccination schedule for the newborn, including the dates and doses of the vaccine.
09
Step 9: Provide any additional notes or comments that may be relevant to the case.
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Step 10: Sign and date the form to certify its accuracy and completeness.
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Step 11: Submit the filled-out Virginia Perinatal Hepatitis B Form to the appropriate authority or healthcare provider for further processing.

Who needs virginia perinatal hepatitis b?

01
Anyone who is pregnant and infected with hepatitis B needs Virginia Perinatal Hepatitis B screening and follow-up interventions.
02
Babies born to mothers who are hepatitis B positive also require Virginia Perinatal Hepatitis B management.
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Virginia perinatal hepatitis B refers to the program and reporting requirements that aim to prevent the transmission of hepatitis B from mothers to their newborns during pregnancy and childbirth in Virginia.
Healthcare providers who are involved in the care of pregnant women and those responsible for reporting cases of hepatitis B in pregnant patients are required to file Virginia perinatal hepatitis B.
To fill out Virginia perinatal hepatitis B, healthcare providers must complete the designated reporting forms with patient information, including the mother's hepatitis B status, and submit them according to state guidelines.
The purpose of Virginia perinatal hepatitis B is to identify pregnant women who are hepatitis B positive to ensure that their infants receive preventive treatment, thereby reducing the risk of hepatitis B transmission.
The information that must be reported includes the mother's hepatitis B status, vaccination status of the infant, and any relevant information regarding follow-up care for the child.
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