FL Jackson Health System Maternal-Fetal Medicine Consultation and/or Transfer of Care Form 2022-2025 free printable template

UHealth Jackson Center for High Risk Perinatal Care Consultation and/or Transfer of Care Form Phone: 3055854636 | Fax: 3055857722 Email: MFMreferrals@jhsmiami.orgPatient Name: ___ DOB: ___ Address:

How to fill out FL Jackson Health System Maternal-Fetal Medicine

How to fill out FL Jackson Health System Maternal-Fetal Medicine Consultation

1. Obtain the FL Jackson Health System Maternal-Fetal Medicine Consultation form from the health system's website or front office.
2. Fill in the patient's personal information, including name, date of birth, and contact information.
3. Provide details about the patient's medical history, including any previous pregnancies, complications, or relevant health conditions.
4. Document the specific reasons for the consultation, such as risk factors, existing conditions, or any symptoms that necessitate specialized care.
5. Include information on current medications and any ongoing treatments related to the patient's health.
6. Ensure all sections of the form are completed accurately to avoid delays.
7. Review the completed form for any errors or omissions before submission.
8. Submit the form to the appropriate department or office within the FL Jackson Health System according to their guidelines.

Who needs FL Jackson Health System Maternal-Fetal Medicine Consultation?

1. Pregnant women with high-risk pregnancies due to medical conditions such as diabetes, hypertension, or autoimmune disorders.
2. Patients with a history of pregnancy complications, including preterm labor or recurrent miscarriages.
3. Individuals carrying multiple pregnancies, such as twins or triplets.
4. Women over the age of 35 who may face increased risks during pregnancy.
5. Patients referred by their primary care physician or obstetrician for specialized maternal-fetal care.

People Also Ask about

What is MFM in OB?

Maternal-Fetal Medicine is a sub-specialty of obstetrics that focuses on the diagnosis and treatment of expectant mothers and their unborn babies.

What is the Emma Clinic at BC Women's?

Placental assessment (EMMA clinic) This assessment is performed between 20 and 24+0 weeks gestational age in singleton pregnancies meeting eligibility critria outlined in the risk assessment form as part of the MFM EMMA clinic referral. All EMMA referrals are triaged by MFM.

Can a MFM deliver a baby?

MFMs work with other OB care providers to ensure high-quality care during labor and childbirth. We provide expert advice on when to induce labor, when and how to monitor the fetal heart rate, and whether a cesarean delivery is indicated.

Why do I need to see an MFM?

Meeting with a Maternal-Fetal Medicine (MFM) specialist before you conceive can help you prepare for a healthy and relaxed pregnancy. MFM specialists can monitor how your pregnancy affects chronic health conditions that involve your heart, blood vessels, lungs, kidneys, immune system, digestive system, and more.

What is the difference between MFM and OB?

OB/GYN vs Maternal Medicine Specialist A Maternal Medicine specialist is a fellowship trained (i.e. additional three years) specialist after completing an OB/GYN training program which focuses primarily on the treatment of complex maternal and fetal problems during pregnancy.

When should you see a MFM?

The most common reason for a woman seeing MFM sub-specialist is that she is considered at risk for complications during pregnancy.

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What is FL Jackson Health System Maternal-Fetal Medicine Consultation?

FL Jackson Health System Maternal-Fetal Medicine Consultation is a specialized service that offers medical evaluation and management for pregnant women who have high-risk pregnancies, ensuring both maternal and fetal health.

Who is required to file FL Jackson Health System Maternal-Fetal Medicine Consultation?

Healthcare providers, such as obstetricians, maternal-fetal medicine specialists, or midwives, are required to file FL Jackson Health System Maternal-Fetal Medicine Consultation when they identify a patient with specific medical conditions or complications during pregnancy.

How to fill out FL Jackson Health System Maternal-Fetal Medicine Consultation?

To fill out the FL Jackson Health System Maternal-Fetal Medicine Consultation, healthcare providers should complete the designated form with patient identification details, medical history, specific concerns, recommended assessments, and additional notes as necessary.

What is the purpose of FL Jackson Health System Maternal-Fetal Medicine Consultation?

The purpose of FL Jackson Health System Maternal-Fetal Medicine Consultation is to provide expert evaluation and care for high-risk pregnancies, improve outcomes for mothers and babies, and guide treatment plans based on clinical findings.

What information must be reported on FL Jackson Health System Maternal-Fetal Medicine Consultation?

The information that must be reported includes patient demographics, medical history, current pregnancy details, complications, previous obstetric history, and any relevant laboratory or imaging results that impact maternal-fetal health.