Medium

Available on

Apple Android Windows

Midwife PDR Consent Mobile App

This Midwife PDR Consent Mobile App allows midwives and birthing centers to collect and share medical health data with the Perinatal Data Registry. Participation in this data collection involves allowing information from a patient’s medical record regarding pregnancy to be entered into a secure online data registry. The care that received during pregnancy, labor, birth and postpartum, and the care that your newborn receives, will not be altered in any way as a result of participation in this data registry. A health record from pregnancy may also be reviewed by one of the project administrators during a site visit to the practice in which you are receiving maternity care in order to confirm that the data entered in the data registry is accurate.

As a practitioner in the medical profession, use this app as a key component for documenting health reference information for live births performed by a midwife or birth center. Document maternal and child health during a birth, noting infectious diseases, severe reactions, and any other significant notes from before, during, and after the pregnancy.

GoCanvas has a collection of apps developed for Midwives and Doulas. They are all Free with your GoCanvas Subscription. Check them out in our Application Store!

  • Lendlease
  • The Cooperative
  • PG&E
  • Red Bull
  • Mirvac

Want to learn more about GoCanvas?

Request a Demo

Take a peek inside the Midwife PDR Consent Mobile App

Included Features

Our App Builder gives you the power to easily add and remove the ones you want. {{controller.show_all ? 'See included features.' : 'See more features.'}}

  • {{data.title}}

Included Fields

Customize to add, remove, or edit any of the fields below.

  • Ico textbox

    1. Title of Data Collection Form:

  • Ico textbox

    2. Administrator:

  • Ico statictext

    3. Purpose: The purpose of this data set is to:

  • Ico statictext

    a.

  • Ico statictext

    b.

  • Ico statictext

    c.

  • Ico statictext

    Procedures: Participation in this data collection involves allowing information from your medica...

  • Ico statictext

    Risks: The risks involved with participation in this project are no more than one would experien...

  • Ico statictext

    Benefits: Potential benefits of participation in this project include the satisfaction of knowin...

  • Ico statictext

    Data Collection & Storage: All information about you and your pregnancy will be kept confidentia...

  • Ico statictext

    8. Contact Information: For related problems or questions regarding your rights, or other questio...

  • Ico statictext

    Consent Statement: I have read or had read to me the proceeding information describing the project.

  • Ico signature

    Signature of Client

  • Ico date

    Date

  • Ico signature

    Signature of Provider

  • Ico date

    Date

  • ...and More!

Related Health Care & Social Services Apps... and they're all free for GoCanvas subscribers!

App Name

Midwife Erythromycin Ophthalm Ointmen...

Antibiotic eye ointment is routinely given to newborns in the hospital. It is given to prevent eye infections that could ...

App Name

Midwife ICI Consent

Intracervical Insemination (ICI) is the placement of semen onto the cervix for the purpose of becoming pregnant. The plac...

App Name

Midwife Medicaid Consent

If your patient currently has Medicaid coverage, you will want to make them aware of your contract status and the requirem...

App Name

Midwife Sperm Sample Consent

Intracervical Insemination (ICI) and Intrauterine Insemination (IUI) involve the placement of sperm or semen into the cerv...

App Name

Newborn Transport Form

If you work on a newborn transport team or hospital transport services, you may find it useful to try the Newborn Transpor...

App Name

Birth Doula Data Collection Form

Please have Doulas answer all applicable items in each category provided in the Birth Doula Data Collection Form mobile a...

App Name

Midwife General Statement and Pregnan...

The Midwife General Statement and Pregnancy Care Agreement mobile app is designed for midwives that offer an alternative...

App Name

Midwife HIPAA Privacy Statement

This notice describes how medical information about you may be used and disclosed and how you can get access to this infor...

More Information