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University of Miami/Jackson Memorial Hospital Fetal Therapy Center Fetal Cordocentesis/Transfusion Referral Form PATIENT INFORMATION, Name / DOB (MM/DD/BY) Last First SSN Address / — State Phone
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What is fetal cordocentesistransfusion referral form?
The fetal cordocentesistransfusion referral form is a document used to refer a pregnant individual for a procedure where blood is transfused into the umbilical cord of the fetus.
Who is required to file fetal cordocentesistransfusion referral form?
The form is typically filled out by a healthcare provider who is recommending the procedure for a pregnant patient.
How to fill out fetal cordocentesistransfusion referral form?
The form should be completed with the patient's medical information, reason for referral, and any relevant test results.
What is the purpose of fetal cordocentesistransfusion referral form?
The purpose of the form is to facilitate the referral process for a fetal cordocentesistransfusion procedure.
What information must be reported on fetal cordocentesistransfusion referral form?
The form should include the patient's name, medical history, reason for referral, and any other pertinent details.
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