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Birthing Center

Pre-Admission Forms

Please read and follow the instructions on the prenatal forms to help us prepare for your stay in the Birthing Center and provide for your personal needs and expectations. If you have any questions, please call the Birthing Center Prenatal Care Coordinators at 262-257-5714.

Please note: these forms are in Adobe Acrobat Reader format. You can download a free copy of Acrobat Reader here.

Dear Expectant Mom

This letter from the Birthing Center's Prenatal Care Coordinators introduces our Right From the Start Program and other helpful information you will need as you prepare for your labor and delivery. Get the form.

Countdown to Parenting

This checklist will help ensure that each important step is completed to help you prepare for the birth of your baby. Please read and follow the instructions carefully. Get the form.

Birthing Center Pre-admission Reservation

The pre-admission form helps us prepare for your admission to the Birthing Center in advance. Please complete and return this form to the Birthing Center as soon as possible. The Admitting Office uses this information to start your chart so it will be ready for your review when you come to the hospital. Get the form.

Self Assessment

A primary goal of our Right From the Start Program is to identify and meet your individual needs during your pregnancy and hospital stay. Please complete this questionnaire and follow the instructions on the Countdown to Parenting form. Get the form.

Your Requests for Personalized Care

This information helps us prepare to meet your expectations for labor pain management and your hospital stay. If you are expecting your first baby, this form will be completed during your birthing classes. Please do not send in this form. If this is not your first baby, please complete this form and send it to the Birthing Center. Get the form.

For Your Baby's Security.

The Birthing Center at Community Memorial Hospital is secured with an alarm system to protect babies from abduction from the unit. Because you and your baby are very important to us, we recommend the following extra safety measures for your protection and peace of mind. Please follow these guidelines. Get the form.

Health Insurance Notification

The Case Management Department at Community Memorial Hospital will obtain pre-certification from your insurance provider for the hospital stay for you and your baby. Please read and follow the instructions provided in this form. Get the form.

Prenatal Classes

We encourage you to learn as much as possible about yourself and your baby by attending prenatal classes whether or not this is your first baby. View the classes.