High-Risk Pregnancy Doctor Note Format

High-Risk Pregnancy Doctor Note Format


Patient Name: ___________________________

Date of Birth: ___________________________

Date of Visit: ___________________________

Diagnosis

The patient has been diagnosed with a high-risk pregnancy. Close monitoring and specialized care are essential to ensure the health and safety of both the mother and the baby.

Recommended Care and Restrictions

The patient is advised to attend regular prenatal appointments and follow up with the obstetrician specialist as scheduled.

Physical activity should be limited as per the doctor's guidance. It is recommended to avoid strenuous activities and follow specific rest periods as advised.

Any prescribed medications should be taken as directed.

Work and Activity Recommendations

It is recommended that work duties be adjusted to accommodate the patient's medical condition. Considerations may include modified or shortened work hours, and the ability to rest as needed.

Activities outside of work should also align with the medical restrictions provided by the healthcare provider.

Next Appointment

The next appointment is scheduled for (date) at (time).

Please contact our office should you have any questions or require further information.

Sincerely,

[Your Name]

Healthcare Provider

Date: [Date]

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