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This form is used for referring patients to Maternal Fetal Medicine at Loma Linda University Children\'s Hospital, including patient and insurance information, maternal history, and reason for referral.
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How to fill out maternal fetal medicine referral
How to fill out maternal fetal medicine referral
01
Gather patient's medical history, including any existing conditions and previous pregnancies.
02
Document current pregnancy details, such as gestational age, complications, and any symptoms.
03
Complete the referral form, providing patient demographics and insurance information.
04
Include relevant lab results, ultrasound reports, or other diagnostic information if applicable.
05
Clearly state the reason for referral and any specific concerns or required evaluations.
06
Review the referral for accuracy and completeness before submission.
07
Submit the referral to the maternal fetal medicine specialist's office.
Who needs maternal fetal medicine referral?
01
Patients with high-risk pregnancies due to pre-existing medical conditions.
02
Expecting mothers over the age of 35.
03
Women with a history of pregnancy complications, such as preterm labor or gestational diabetes.
04
Patients carrying multiples (twins, triplets, etc.).
05
Individuals with abnormal prenatal screening results or genetic concerns.
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What is maternal fetal medicine referral?
Maternal fetal medicine referral is a process where a healthcare provider refers a pregnant patient to a specialist in maternal-fetal medicine for advanced care and management of high-risk pregnancies.
Who is required to file maternal fetal medicine referral?
Typically, any healthcare provider involved in the care of a pregnant patient, such as obstetricians or primary care physicians, may be required to file a maternal fetal medicine referral when additional specialized care is needed.
How to fill out maternal fetal medicine referral?
To fill out a maternal fetal medicine referral, provide patient information, including medical history, reason for referral, any relevant test results, and specify the conditions that necessitate specialist evaluation.
What is the purpose of maternal fetal medicine referral?
The purpose of maternal fetal medicine referral is to ensure that pregnant patients with potential complications receive specialized care and comprehensive management to improve outcomes for both the mother and the fetus.
What information must be reported on maternal fetal medicine referral?
The referral must report the patient's demographic information, medical history, the specific concerns or conditions prompting the referral, relevant test results, and any previous treatments or interventions.
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