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Antenatal Screening for Newborn Hepatitis B Prophylaxis
Another "mandatory" form to be completed for FHA.
Prenatal Investigation Package
Canadian Blood Services Prenatal Screen Requisition
Link to BC/Yukon Requisition
St Pauls Reproductive Mental Health Program
Link to automated hystory taking for OB and GYN
Diane 35 Checklist
From John Yap: For those who prescribe it, this may be a good reference and “informed consent” form for Diane-35, or any OCP for that matter! Comments welcome. JohnY
Maternity Care Calendar and Pregnancy Calculator 2014
Link to the folder containing the Maternity care calendar and the pregnancy calculator for 2014. Stored with the add ons for the BCAR
Blood Products Consent form
From Kat Montgomery - This are specific to our clinic with our logo and address, but could easily be adapted for anyone else. This is an html form. There is a reference to a logo but it is specific for Pomegranate Midwives. JohnR.
This is a stand alone Win Rho prescription developed by Kat Montgomery and Pomegranate Midwives. It is HTML only and can be customized for other clinics. JohnR.
BC Pap smear 2017
RAMQ Obstetrics Forms 2015
Link to: RAMQ Obstetric Forms. Created by Nicole Joseph of the Queen Elizabeth Medical Group (McGill Univeristy Health Centre) with input from Dr, Mark Roper and Earl Wertheimer.
Combined Hematology Gynecology referral eform Vancouver 2015
Link to Combined Hematology Gynecology referral eform Vancouver 2015
Harmony Perinatal Testing 2016
Updated to the 2016 version October 22 - 2016. Link to 2015 version of the Harmony Perinatal testing form.
eForm for Consent to Cord Blood Collection
From Kat Montgomery: Note that this is only the consent. Patients are expected to read the 9 page information handout before signing (easily read online at Canadian Blood Services). And in BC, this is only relevant to BC Women's, since they are the only hospital doing collections.
Colposcopy Short Stay form 2016
This form has been updated to reflect the latest version of the Colposcopy Short Stay form, and some added code has been placed
Point Of Care UltraSound (POCUS) Obstetrical Worksheet/Report 2016
Nov 12 2017 - Now calculates Gestational age based on NICHD equation. Also stand alone version is now available for those without an oscar server. October 20th - now calculates unweighted average of estimated gestational age. October 8th 2016 - updated to calculate EFW based on a variety of inputs. - August 9 2016 - updated so that calculations for gestational age can be made on FL, AC, HC, and BPD. FL and AC calculations are done via equation. HC and BPD calculations are done based on a table. July 24 2016 - updated to include calculations for gestational age based on AC and HC. Now with links to source material for the calculations. July 22nd - Updated to now include calculation of gestational age based on femur length or biparietal diameter. With the increased use of Point of Care Ultrasound (POCUS) providers are being encouraged to document their findings. This is a basic worksheet to help in that effort. It pushes and pulls various measurements such as Gravity, Parity, LMP, EDC, and helps with calculation of gestational age based on CRL (thanks to Kat Montgomery for the js script that helps with this). JohnR.
Counsyl - LifeLabs Genetics – Private Pay Form – Patient Consent Form 2017
Counsyl - LifeLabs Genetics – Private Pay Form – Patient Consent Form - This consent form reviews the benefits, risks, and limitations of undergoing DNA testing for the genetic disorders available through the Counsyl Family Prep Screen
LifeLabs Panorama NIPT (Private Pay)
Two eForms required - NIPT and consent forms. They are linked, so keep names intact.

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