Prenatal questionnaire

In order to best take care of you and your baby during pregnancy, you and your provider will discuss important parts of your health history that may have some impact on your pregnancy. These include diseases, operations, and other pregnancies, as well as some important questions about your family’s health history.

To find out any important concerns that might have an impact on your care during pregnancy, we ask all our expectant moms to print out and complete this questionnaire. Bring it to your first visit so this information can be reviewed and discussed with your provider.