Training Quiz - Healthy Start Coalition of Orange County

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Prenatal Provider Training Quiz

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First and Last Name *

Title/Position: *

Email address *

Provider office name and/or OPR # *

Provider office address *

1. What does Healthy Start legislation require prenatal providers to do? *

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? *

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? *

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? *

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)? *

N/A No Yes

6. What is the answer to # 20 (trimester at 1st prenatal visit)? *

N/A 1st Trimester 2nd Trimester 3rd Trimester

7. What is the total screening score (don't forget your answers to questions # 19 & 20)? *

2 4 6

8. Would you refer for services? *

Yes No

9. The training information will help me in the Healthy Start screening process. *

Yes Somewhat No

10. I learned new information I didn't previously know. *

Yes Somewhat No

Do you have any questions or comments? *

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

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