Click on a form or a link below to view a PDF version of our current client forms.
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Informed Disclosure and Consent for Midwifery CareThis form is required for all new clients. |
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Midwifery Emergency Care PlanThis form must be completed by all new clients.
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AZ Dept of Health - Informed ConsentThe state requires that all midwifery clients sign this form to confirm that you have received all required information and resources. |
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AZ Dept of Health - Assertation to Decline On-Going Required TestsThe State of Arizona requires this form if you are going to decline any of their required pregnancy tests routinely done during prenatal visits. |
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AZ Dept of Health - Assertation to Decline Tests Required within 28 WeeksThis form is required to decline specific tests that the state requires of all mothers by the 28th week of pregnancy. |
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Home Birth Supply List - Please Purchase These Items to Prepare for Home BirthWe have prepared a birth kit of specialized items that may not be commonly purchased at a local grocery or department store. You can purchase our birth kit at this link: Two items need probably to be purchased online at these links:
The third part of this is a list of items commonly available at local retailers (or online). Print the form below out with you and take to local stores. |
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Records Release Form - To Request Records from Another Healthcare providerComplete this form if you have been treated by another health care professional during this or previous pregnancies. |
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Midwifery Consult and Transfer of Care StandardsThis form identifies situations where a medical consultation or transfer of care is required under Arizona rules and statutes. |
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