Free Pre-Natal Care Checklist Outline Template
Pre-Natal Care Checklist Outline
Prepared for: [YOUR NAME]
Prepared by: [YOUR COMPANY NAME]
Contact Details: [YOUR COMPANY ADDRESS], [YOUR COMPANY EMAIL], [YOUR COMPANY NUMBER]
Section 1: Key Medical Appointments
|
Appointment Type |
Recommended Date |
Status |
|---|---|---|
|
First Trimester Check-Up |
January 10, 2050 |
|
|
Ultrasound (12 Weeks) |
February 5, 2050 |
|
|
Glucose Screening |
April 15, 2050 |
|
|
Third Trimester Check-Up |
July 20, 2050 |
|
|
Birth Plan Consultation |
August 1, 2050 |
|
Section 2: Essential Tests and Vaccinations
☐ Blood Pressure Monitoring (Monthly)
☐ Blood Tests (Iron, Rh Factor, etc.)
☐ Gestational Diabetes Screening
☐ Tdap Vaccination (Between 27–36 weeks)
Section 3: Lifestyle Recommendations
☐ Nutrition Plan: Follow balanced meals rich in folic acid, calcium, and iron.
☐ Exercise Routine: Engage in low-impact activities like prenatal yoga or walking.
☐ Mental Health: Attend at least one stress-management session.
☐ Education: Complete a childbirth preparation class by August 15, 2050.
Section 4: Emergency Contacts
|
Contact Name |
Role |
Phone Number |
|---|---|---|
|
Primary Doctor |
Obstetrician |
222 555 7777 |
|
Hospital |
Delivery Center |
222 555 7777 |
|
[YOUR COMPANY NAME] |
Support Line |
[YOUR COMPANY NUMBER] |
Section 5: Notes and Follow-Up
-
Questions for the Next Visit:
☐________________________________________________________
☐________________________________________________________ -
Additional Notes:
☐________________________________________________________
☐________________________________________________________
Call to Action
Stay proactive about your health and your baby's well-being! Contact us at [YOUR EMAIL] or call us at [YOUR COMPANY NUMBER] to schedule your next appointment or for further guidance.
