Pregnancy notification form - Blue Cross and Blue Shield of South 2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your personal information in the designated fields, including your name, date of birth, and member ID number. Ensure accuracy for seamless processing.
3. Fill in your complete mailing address and phone numbers. This information is crucial for communication regarding your pregnancy notification.
4. Provide details about your obstetrician or midwife practice, expected due date, last menstrual period (LMP), and hospital name where you plan to deliver.
5. Record your first prenatal appointment date along with your present weight and height. If applicable, indicate whether you have had a previous C-section and provide the reason.
6. Check any applicable risk factors that may pertain to your pregnancy. This helps in assessing any additional care you may need.
7. Finally, ensure that the physician's signature is included along with the date before submitting the form.

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