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How to use or fill out RequestforUSMFMServicesFormSept10 - med unc with our platform
- Click ‘Get Form’ to open the Request for Ultrasound/Maternal-Fetal Medicine Services form in the editor.
- Begin by filling in the 'Preferred Location' section, selecting either UNC-Chapel Hill or UNC at Rex-Raleigh.
- In the 'Appointment Information' section, enter the patient's name, medical record number, preferred appointment date and time, and details about previous ultrasounds.
- Complete the 'Request for Genetic Counseling and/or Ultrasound' section by indicating the required diagnostic tests and providing necessary prenatal lab values.
- Fill out the 'Request for MFM Consultation' section with relevant indications and ensure to fax any required medical records as specified.
- Finally, review all entered information for accuracy before submitting your completed form via fax to the provided number.
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