First Visit

Bring the following completed forms and other items to your first appointment.

Medical Records

A copy of all obstetrical records and any medical records for conditions that are being treated or could affect your pregnancy/health.

Diet Chart (PDF file)

Please bring one week worth of a food journal. You can go here to print it out.

Client History/Personal Information

Please take some time to fill this out and bring it with you. This helps Pat get to know you better and understand any emotional issues concerning pregnancy and birth that you may be facing. You can go here to print it out.

Medical Information (PDF file)

Please fill out this form concerning some of your medical information and bring it with you. You can go here to print it out.

Client History (PDF file)

Please fill out this form concerning more medical history and bring it with you. Part II should be filled out by the person who will be coaching you through labor. You can go here to print it out.

Home Birth (PDF File)

This form is to help you consider the feelings, responsibilites, advantages, and disadvantages of a home birth. Please fill this out and bring it with you. You can go here to print it out.

List of Support

Please bring a list of where you get your support. Who in your life gives you the emotional and physical support you need? How do they provide this support to you?