AF Form 3247: Neonatal Admission Note (Download PDF)

AF Form 3247: Neonatal Admission Note (Download PDF) – AF Form 3247, officially titled Neonatal Admission Note, is a standardized U.S. Air Force medical form used to document the admission of newborn infants (neonates) into military treatment facilities (MTFs). It serves as a critical component of inpatient medical records for newborns requiring specialized care, often in neonatal intensive care units (NICU) or newborn nurseries.

This form ensures consistent, comprehensive documentation of a neonate’s condition upon admission, supporting high-quality care, legal compliance, and continuity across Air Force healthcare settings.

What Is AF Form 3247 Used For?

Neonates—babies in the first 28 days of life—often need close monitoring due to prematurity, low birth weight, respiratory distress, infections, congenital conditions, or complications from delivery. AF Form 3247 provides a structured template for physicians, neonatologists, pediatricians, and neonatal nurses to record essential history, physical findings, assessments, and initial plans.

The form is part of the Air Force inpatient record jacket and is referenced in Department of Defense and Air Force health record policies, including DHA-PM 6025.02 (DoD Health Record). It pairs with related forms such as:

  • AF Form 3244 (Pediatric Admission Note)
  • AF Form 3248 (Neonatal Patient Care Plan)

Proper use of AF Form 3247 helps military healthcare teams meet standards for documentation, support performance improvement programs, and ensure compliance with clinical quality requirements under AFI 44-119 and related instructions.

Who Uses AF Form 3247?

  • Neonatologists and Pediatricians at Air Force MTFs
  • Neonatal Nurse Practitioners and Registered Nurses
  • Residents and medical staff involved in newborn care
  • Labor & Delivery and NICU teams transitioning babies from delivery to admission

It is primarily used in U.S. Air Force medical treatment facilities worldwide, though similar documentation practices apply across DoD services.

Key Sections of AF Form 3247 Neonatal Admission Note

While the official PDF provides the exact layout, AF Form 3247 typically captures the following critical elements (based on standard neonatal admission documentation practices in military and civilian settings):

1. Patient Identification and Administrative Data

  • Infant’s name, date of birth, time of birth, sex, and medical record number
  • Admission date and time
  • Gestational age, birth weight, length, and head circumference
  • Apgar scores (1-minute and 5-minute)
  • Delivery details (vaginal, cesarean, etc.)

2. Maternal History

  • Maternal age, gravida/parity, prenatal care history
  • Complications during pregnancy (gestational diabetes, hypertension, infections, etc.)
  • Medications, substance use, and group B strep status
  • Maternal serologies and screening results

3. Birth and Delivery History

  • Mode of delivery and any complications (e.g., meconium, fetal distress)
  • Resuscitation efforts at delivery
  • Cord blood gas results (if applicable)

4. Neonatal History and Reason for Admission

  • Primary reason for admission (prematurity, respiratory distress, hypoglycemia, sepsis evaluation, etc.)
  • Events since birth (feeding tolerance, temperature stability, voiding/stooling)

5. Physical Examination

  • Vital signs
  • General appearance, skin, head, eyes, ears, nose, throat
  • Cardiovascular, respiratory, abdominal, genitourinary, musculoskeletal, and neurological findings
  • Any anomalies or abnormalities noted

6. Assessment and Plan

  • Problem list or working diagnoses
  • Initial management plan (labs, imaging, medications, consultations, monitoring)
  • Nutrition plan (breast milk, formula, parenteral nutrition)
  • Follow-up and disposition

The form emphasizes objective data, clear assessment, and a structured plan to support multidisciplinary neonatal care.

Download the Official AF Form 3247 PDF
Access the most current version directly from the official Air Force e-Publishing site:
https://static.e-publishing.af.mil/production/1/af_sg/form/af3247/af3247.pdf

Always verify you are using the latest revision when completing records in your MTF.

Why Proper Documentation Matters in Neonatal Care?

Accurate completion of AF Form 3247 supports:

  • Patient safety and continuity of care in the NICU
  • Risk management and quality improvement programs
  • Legal and regulatory compliance within the Military Health System (MHS)
  • Transition of care between shifts, teams, and facilities (including aeromedical evacuation)

Neonatal patients are particularly vulnerable. Thorough admission notes help identify issues early, such as respiratory distress syndrome, neonatal sepsis, hyperbilirubinemia, or feeding difficulties, which are common reasons for NICU admission.

Best Practices for Completing AF Form 3247

  • Complete the form promptly upon admission
  • Use objective, factual language and avoid abbreviations where possible (or use only approved ones)
  • Document all relevant positive and negative findings
  • Ensure signatures, dates, and times are included
  • Link findings to a clear problem-oriented assessment and plan
  • File the form appropriately in the inpatient record per DHA and Air Force guidelines

Military providers should also reference local MTF policies, as well as broader DoD health record instructions.

  • Air Force e-Publishing (official source for all AF forms)
  • DHA-PM 6025.02 – DoD Health Record guidance
  • American Academy of Pediatrics (AAP) guidelines on neonatal care and levels of care
  • Clinical resources on common neonatal conditions (e.g., March of Dimes, Stanford Children’s Health NICU information)

Note: This article is for informational purposes and is intended to help U.S. Air Force and DoD medical personnel understand the purpose and use of AF Form 3247. Always consult the official form instructions, your facility’s medical records department, and current Air Force instructions for authoritative guidance. Forms and policies can be updated; check e-publishing.af.mil for the latest version.

If you are a medical provider stationed at an Air Force base and need training on neonatal documentation or related forms (such as the Neonatal Patient Care Plan), contact your MTF’s Medical Staff Office or Clinical Quality Management team.

Keywords: AF Form 3247, Neonatal Admission Note, Air Force neonatal documentation, AF IMT 3247, military NICU admission, DoD newborn records, Air Force medical forms.