Get Nz Canterbury Induction Of Labour Referral Form 2014-2025

Filling out the NZ Canterbury Induction Of Labour Referral Form online can streamline the referral process for individuals seeking induction of labour. This guide provides clear, step-by-step instructions to help users complete the form accurately and efficiently.

Follow the steps to complete the Induction of Labour Referral Form

1. Click the ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering the patient’s surname in the designated field. Ensure that the spelling is accurate to avoid any delays.
3. Next, fill in the National Health Index (NHI) number provided to you. This number is crucial for patient identification.
4. Input the first name of the patient as it appears on their ID.
5. Record the date of birth (DOB) in the specified format to ensure clarity.
6. Provide the full address, including street name, suburb, and postcode. Double-check for accuracy.
7. Enter the patient's home and mobile telephone numbers. This information is essential for contact purposes throughout the induction process.
8. Document the estimated due date (EDD) according to the last menstrual period (LMP). If applicable, include the ultrasound (USS) EDD.
9. Complete the gravida and parity fields, which indicate the patient’s pregnancy history.
10. Specify the suitability for paper triage by checking the relevant criteria boxes.
11. Fill in the Lead Maternity Carer (LMC) or private consultant details, including their name and pager.
12. If necessary, attach copies of the ultrasound reports and fill out the maternity booking details.
13. Add the indication for induction and sign the referral by the person making it.
14. If applicable, provide the Bishop Score by entering the total score and relevant details.
15. Select the method of induction and note the time and date if already booked.
16. Indicate whether the criteria for the paper clinic were met, and if not, follow the instructions for obstetric review.
17. After completing the form, save your changes. You may have options to download, print, or share the form as needed.

Complete the Induction Of Labour Referral Form online to ensure a smooth submission process.