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MATERNALFETAL MEDICINEPATIENT REFERRAL FORM Date of Referral:Boise 900 N. Liberty St., Suite 206 Boise, ID 83704Nampa 4424 E. Flamingo Rd., Suite 220 Nampa, ID 83687Phone: (208) 3021100Phone: (208)

How to fill out maternal-fetal medicine patient referral

How to fill out maternal-fetal medicine patient referral

1. Obtain necessary information from the requesting provider, including patient's medical history, current pregnancy status, and reason for referral.
2. Complete the maternal-fetal medicine patient referral form, providing detailed information about the patient's condition and any relevant test results.
3. Include any supporting documentation, such as ultrasound images or laboratory reports, with the referral form.
4. Submit the completed referral form and supporting documents to the maternal-fetal medicine department through the preferred method of communication, such as fax or secure online portal.

Who needs maternal-fetal medicine patient referral?

1. Pregnant women with high-risk pregnancies, including those with chronic medical conditions like diabetes or hypertension, multiple gestations, history of pregnancy complications, or fetal anomalies.
2. Women who have experienced recurrent pregnancy loss or preterm birth may also benefit from a maternal-fetal medicine patient referral.

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What is maternal-fetal medicine patient referral?

Maternal-fetal medicine patient referral is a process where healthcare providers refer pregnant women with high-risk pregnancies to specialists in maternal-fetal medicine for advanced care and monitoring.

Who is required to file maternal-fetal medicine patient referral?

Healthcare providers including obstetricians, midwives, and primary care physicians are required to file maternal-fetal medicine patient referrals when necessary.

How to fill out maternal-fetal medicine patient referral?

Maternal-fetal medicine patient referral forms can be filled out by providing relevant medical information about the pregnant woman's condition and the reason for referral to the specialist.

What is the purpose of maternal-fetal medicine patient referral?

The purpose of maternal-fetal medicine patient referral is to ensure that pregnant women with high-risk pregnancies receive specialized care and monitoring to optimize outcomes for both the mother and baby.

What information must be reported on maternal-fetal medicine patient referral?

The maternal-fetal medicine patient referral should include the pregnant woman's medical history, current pregnancy status, reason for referral, and any relevant test results or imaging studies.