FACT SHEET Healthy Start Screening Forms
Healthy Start has two risk screening forms all mothers should take a few minutes to complete. The results of the screenings, which are kept private, are the gateway to learning more about the Healthy Start program and local resources so babies may have the healthy start they deserve. Mothers may grant Healthy Start permission to gather anonymous, statistical information from the form, which the program uses to collect population data to help improve health care for all of Florida’s moms and babies. A total of 156,164 women and 189,321 infants were screened for Healthy Start in 2006. Prenatal Risk Screening Form The Healthy Start Prenatal Screening Form is for all pregnant women in Florida, regardless of age, race, or economic status. It is a free, one-page questionnaire designed to identify any factors about a pregnant woman’s health, current living environment, or everyday activities that may negatively impact a mother or baby. The prenatal form should ideally be completed at the first prenatal visit, but can be filled out during any prenatal care visit or at a local health department. The earlier a pregnant woman fills out the form, the sooner she can learn about any risk factors that could affect her health and the health of her baby, and the faster Healthy Start can begin working with mothers to minimize adverse outcomes. Existing legislation requires all prenatal care offices and birthing facilities in Florida to offer pregnant women and newborn infants the Healthy Start Prenatal Screening Forms. If a provider neglects this responsibility, a mother should take an active role in her health and the health of her baby and request the screening.
Infant Risk Screening Form The Healthy Start Infant Screening Form is for all newborn infants in Florida, regardless of age, race, or economic status. The Infant Screening Form consists of questions that identify factors about a baby’s health at birth that could adversely affect the baby’s first year of life. Most often, this form is completed before a mother and her new baby leave the hospital or birthing facility. In some instances, a nurse, doctor, or Healthy Start representative is available to explain the purpose of the form and help answer any questions a mother may have.
The Next Step Once a mother has completed a risk screen, it will be reviewed by her health care provider to determine if she should be referred to Healthy Start. If she is referred, a Healthy Start care coordinator will contact the mother to discuss the Healthy Start program, explain her screening results, and answer any questions she may have.