Get To Download The Follow-up Form - Antiretroviral Pregnancy Registry
How it works
-
Open form follow the instructions
-
Easily sign the form with your finger
-
Send filled & signed form or save
How to fill out the To Download The Follow-up Form - Antiretroviral Pregnancy Registry online
Filling out the To Download The Follow-up Form for the Antiretroviral Pregnancy Registry is an essential task for accurately documenting pregnancy outcomes related to antiretroviral treatment. This guide will help you navigate each section and field to ensure you provide the necessary information effectively.
Follow the steps to complete the Follow-up Form accurately.
- Press the ‘Get Form’ button to access the form and open it for completion.
- Enter the Patient (Log) ID in the designated field at the top of the form, which is assigned by the Registry.
- Complete the Maternal Information section. Indicate if the patient is participating in a clinical study by selecting 'Yes', 'No', or 'Unknown'. If the answer is 'No', proceed to section 2.
- If 'Yes' is selected in step 3, provide the protocol number and specify if the clinical study was conducted in pregnant women.
- Move to the Fetal Outcome section. If there are multiple outcomes, remember to fill out a Follow-up Form for each infant.
- In the Birth Defect section, check ‘Yes,’ ‘No,’ or ‘Unknown’ regarding any structural birth defects noted. If ‘Yes’ is checked, list the specific defects in Section 3.
- Indicate the outcome of the pregnancy by checking the applicable option: ‘Live Infant’, ‘Spontaneous abortion’, ‘Induced abortion’, or ‘Stillbirth’.
- Provide the outcome date using the format DD/MMM/YYYY. Fill in the gender, length, gestational age, birth weight, and head circumference of the infant in the respective sections.
- If applicable, detail any factors that may have contributed to fetal loss in Section 4.
- In the Birth Defects section, list any birth defects and specify if they were attributed to antiviral therapy using the coded options provided.
- Complete the Health Care Provider Information section with your details, including name, specialty, and contact information.
- Review the completed form for accuracy before saving your changes. You can then download, print, or share the form as needed.
Start completing the To Download The Follow-up Form for the Antiretroviral Pregnancy Registry online today.
No, antiretroviral therapy should generally be continued during pregnancy unless otherwise directed by your healthcare provider. Discontinuing therapy could increase the risk of HIV transmission to the baby and harm maternal health. Communication with your healthcare team is essential to ensure safety and effectiveness. Utilize resources like To Download The Follow-up Form - Antiretroviral Pregnancy Registry for managing your treatment plan.
Industry-leading security and compliance
-
In businnes since 199725+ years providing professional legal documents.
-
Accredited businessGuarantees that a business meets BBB accreditation standards in the US and Canada.
-
Secured by BraintreeValidated Level 1 PCI DSS compliant payment gateway that accepts most major credit and debit card brands from across the globe.