Prenatal (Genetic) Questionnaire Prenatal Questionnaire 2026

1. Click ‘Get Form’ to open the Prenatal (Genetic) Questionnaire in the editor.
2. Begin by entering today's date, your name, date of birth, and age at the top of the form. This information is essential for your healthcare provider.
3. List any allergies you have and provide the first day of your last menstrual period. This helps in assessing your medical history.
4. Complete the pregnancy history chart by detailing all pregnancies, including miscarriages and terminations. Fill in each year, type of birth, weight, sex, length of pregnancy, and any complications.
5. In the genetics screening section, circle or mark responses regarding family history and genetic conditions. Be thorough to ensure accurate risk assessment.
6. Provide details about feeding preferences (breast or bottle), anesthesia choices for delivery, and pediatrician selection.
7. Answer past medical history questions honestly. Include any previous surgeries or hospitalizations and any concerns regarding this pregnancy.

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