FREE 7+ Proof of Pregnancy Forms in PDF

Being pregnant requires a woman to undergo several challenges for seven to nine months. This is why organizations and institutions offer special services for pregnant clients to ensure that the client is safe as well as the baby that she is carrying in her womb.

However, before any woman can claim the benefits and special services of an organization, she must first prove that she is pregnant especially if she is still in her first tri-semester where the baby bump is not yet that visible. For this, proof of pregnancy forms will have to be submitted to the organization to validate her pregnancy claim form.

• Medical Clearance Forms
• Maternity Allowance Forms

Pregnancy Certificate Form

Pregnancy Verification Form

Pregnancy Medical Certificate Form

What Are Proof of Pregnancy Forms?

Proof of pregnancy forms are documents which are to be presented by a woman to prove that she is pregnant. These forms are often required by airlines and medical institutions. You may also see Dental Medical Clearance Forms

The reason why these documents are required is to ensure that the right services are provided to the pregnant woman and that the services or the procedures will not cause any harm to both the woman and her child. Moreover, a pregnant woman must also disclose all relevant details and information about her pregnancy that the institution and organization should know in order to cater to her needs.

Proof of Pregnancy Form Varieties

Air Travel Pregnancy Certificate Form – This is the document to use if a pregnant passenger wants to travel using an aircraft. The form contains three sections to be filled out by a nurse and the pregnant passenger herself. The first section of the form is intended to be completed by the nurse wherein the pregnant passenger’s name will have to be stated along with her personal identification number, location, care unit, the number of weeks being pregnant, and the estimated date of delivery. You may also see Sample Disability Forms

Further details about the pregnancy will have to be disclosed in the first section as well such as the pregnancy type and whether or not the pregnant passenger can travel without risks. And to complete the first section, the nurse must state the time and place where the certificate was filled out, and she must state her name and signature on the allotted area. You may also see Affidavit of Paternity Forms

Air Travel Pregnancy Certificate Form

Pregnancy Affidavit Form

The second section of the form is to be completed by the pregnant passenger. This is where the details of her flight will be documented such as the route, flight number, and the flight date. Her contact information should also be indicated in the form along with her email address.

In addition, the third section is intended to document the pregnant passenger’s consent with regards to the request of the airline organization to use her information or personal data. She must affix her signature and state her name and date on the signature block in order to complete the certificate form.

Pregnancy Affidavit Form – Pregnant women who have chosen to undergo homebirth rather than be admitted to a hospital or maternity center are the target users of this form. Basically, a pregnancy affidavit form will document the details of the birthing. The first two sections of the form must be completed by the affiant and a witness while the last section is for the notary public. You may also see Massage Consent Forms

The name of the mother of the newborn child, the name and address of the witness forms, and a few questions regarding the pregnancy and the birthing are the contents of the first section of the form while the second section will have to be filled out by the witness wherein his name and signature must be affixed. Moreover, to make the affidavit form be a legal document, a notary public must sign and seal the form before it will be submitted for the child’s birth registration form.

Pregnancy Attestation Form

Pregnancy Test Confirmation Form

Pregnancy Attestation Form – Before a pregnant woman will be permitted to undergo medical procedures, consultations, and even dental services, she must have a pregnancy attestation form completed and signed by her obstetrician-gynecologist or OB-GYN. You may also see Questionnaire Forms

In the form, the OB-GYN will need to state the name of her patient or the pregnant woman along with the estimated delivery date and the medical limitations and restrictions which should be noted before procedures will be undergone. Then, the OB-GYN must affix her signature below the affirmation statement with her name and the date when she filled out the pregnancy attestation form. You may also see Free Medical Forms

Pregnancy Test Confirmation Form – There are some pregnancies where women produce less human chorionic gonadotropin or hCG levels which results in a false-negative pregnancy test. This is the reason why taking multiple pregnancy medical tests is essential especially if there are prevalent pregnancy symptoms involved.

For this, a pregnancy test confirmation form will be provided to the woman who took the pregnancy test in the doctor’s office or clinic. The form will document the name of the subject of the test, the date when the test was taken, the test results, and the remarks and signature form of the doctor. You may also see Risk Assessment Form Samples

Pregnancy Test Visit Form

Pregnancy Report Form

Pregnancy Test Visit Form – This is another document which can be used to record and prove the health and pregnancy status of a female patient. There are six sections in the form wherein the first section is to be filled out by the patient or the client and is intended to document her reason for visiting the doctor’s office along with her common allergies, menstrual period information, the birth control method used by her and her partner, and a set of yes or no questionnaire which will aid in further identifying her pregnancy status. You may also like Chiropractic Intake Forms

The second section, on the other hand, centers on relationship and safety matters revolving around possible abuse symptoms that she had experienced from her partner.

In the third section, the staff of the clinic or the doctor’s office will indicate subjective comments and recommendations about the patient’s concerns while the fourth section collects the objective comments based on the laboratory test results of the patient.  You may also see New Patient Intake Forms

The fifth section is where the medical assessments and the desires of the patient or client will be stated. And lastly, the sixth section details the pregnancy plans and suggestions if ever the pregnancy test result is positive.

To conclude, proof of pregnancy forms are also to be used for clearance forms purposes by allowing a pregnant woman to continue undergoing a procedure or travel using varying means of transportation.

However, the organization who will be receiving the form should also verify the parties who have signed the form before clearance will be given to ensure that the submitted form is legal and legit.