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Prenatal Provider Training Quiz
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Indicates required field
First and Last Name
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Title/Position:
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Email address
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Provider office name and/or OPR #
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Provider office address
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1. What does Healthy Start legislation require prenatal providers to do?
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Complete a Healthy Start screening form for all prenatal patients
Provide an explanation about Healthy Start services
Maintain a completed screen in the patient's medical record
All of the above
2. What does the screening form assess?
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A pregnant woman's need for community resources
The fetus's risk for genetic abnormalities
A pregnant woman's risk for preeclampsia
A pregnant woman's risk for delivering preterm or a low birth weight baby
3. Who should you refer for Healthy Start services?
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A woman who scores 6 or more
A woman who scores 5 or less based on your professional judgement
A woman whose source of insurance is Medicaid
All women if you choose
4. What will happen if screening forms are submitted incomplete?
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Phone attempts will be made to your office
In-person visits will be made to your office
Letters will be sent
All of the above
Use the example screening form (click to download at the top of this web page) to answer the following 4 questions beginning with: what is the answer to question #19 (pregnancy interval)?
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N/A
No
Yes
6. What is the answer to # 20 (trimester at 1st prenatal visit)?
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N/A
1st Trimester
2nd Trimester
3rd Trimester
7. What is the total screening score (don't forget your answers to questions # 19 & 20)?
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2
4
6
8. Would you refer for services?
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Yes
No
9. The training information will help me in the Healthy Start screening process.
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Yes
Somewhat
No
10. I learned new information I didn't previously know.
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Yes
Somewhat
No
Do you have any questions or comments?
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I agree to receiving marketing and promotional materials
Submit
To complete the quiz, you will need to view a sample screening form found here:
Download Sample Form