Get Nz Nelson Bays Primary Health Lactation Consultant Referral 2014-2026

This guide provides clear and supportive instructions for completing the NZ Nelson Bays Primary Health Lactation Consultant Referral form online. Following these steps will ensure that all the required information is accurately provided to facilitate effective referrals.

Follow the steps to complete the referral form effortlessly.

1. Press the ‘Get Form’ button to access the NZ Nelson Bays Primary Health Lactation Consultant Referral form and display it in your editor.
2. Begin by filling out the 'Referred By' section with your name and position, along with the date of the referral. Additionally, provide your phone number and email address.
3. Input the baby’s name, date of birth (DOB), and National Health Index (NHI) number. Repeat this for the mother’s details as well.
4. Indicate the gestational age at birth and the parity, which refers to the number of pregnancies carried to a viable gestational age.
5. Select the ethnicity for both the baby and mother from the provided options: NZ European, Maori, Pacific, Asian, or Other.
6. Fill in the birth weight of the baby and then enter the address and telephone number of the mother.
7. Document the current weight and age of the baby and indicate the birth mode by selecting the appropriate option: Vaginal, Vaginal Assisted, or Caesarean.
8. State the smoking status of the mother by providing the necessary information.
9. Confirm that maternal consent has been obtained for referral by checking the box provided. If relevant, enter any other pertinent birth history and breastfeeding history.
10. Identify the services currently involved in the care by checking the relevant options such as LMC, Mum4Mum, Well Child, GP, Tamariki Ora Provider, or Other.
11. Specify the reason(s) for the referral for both the baby and the mother, checking the applicable boxes and providing additional details for 'Other' if necessary.
12. Finally, outline what has been tried in terms of the breastfeeding plan to date.
13. Once the form is completed, save your changes. You may opt to download, print, or share the completed referral form as needed. Ensure to fax or email it to Debra Hardcastle, Lactation Consultant Facilitator, at the provided contact details.

Complete your NZ Nelson Bays Primary Health Lactation Consultant Referral online today to ensure the best care for mothers and babies.