Client forms

Client Forms

Things to Read before your first visit

Please review the following documents before your first visit so that we can answer any questions that you may have.

Financial Agreement
Insurance FAQs
Regulatory Disclosures
Regulatons for CPMs

Things to fill out and bring to your first VISIT

Fill out and bring the following forms to your first prenatal visit. You can fill them out by hand or use the "fillable" versions and then just print them out.

Medical History Form
Medical History Form-Fillable
Financial Contract
Regulatory Disclosure Signature Page Directions and Transport Plan Disclosure for Home Birth Insurance Benefits Worksheet (for clients with private health insurance)

ADDITIONAL HANDOUTS

Supplies you will need for your homebirth
Diet Diary
Pregnancy Tea
Pediatrician Information Records Request (from previous provider) Records Request (from Mountain View Midwives)
Evaluation Form
Practice Guidelines

If you are unable to access the forms for any reason, please email us and we will send them to you.