Follow the steps to complete the Maryland Prenatal Risk Assessment

1. Press the ‘Get Form’ button to access the Maryland Prenatal Risk Assessment form and open it for completion.
2. Begin by entering today’s date and the ten-digit NPI number in the designated fields at the top of the form. Ensure accuracy for future reference.
3. Complete the provider's information by filling out the provider name and phone number directly below the NPI number.
4. In the demographic information section, provide the client's last name, first name, and any relevant address details, including house number, street name, apartment number, state, and zip code.
5. Input the client’s contact numbers, including home, emergency, and cell phone details. If the client does not possess a social security number, denote this by entering zeroes.
6. Mark the relevant race and language barriers as applicable. Be sure to check off the educational level and marital status, as it is essential for assessment.
7. Proceed to the OB history section, indicating relevant details such as the trimester of the first prenatal visit, prenatal care transfers, and any prior medical history.
8. In the assessment information section, check all applicable medical and psychosocial risks associated with the current pregnancy. Take special care to mark any current medical conditions.
9. Use the comments boxes to provide additional information about psychosocial or medical risks if necessary, ensuring that any clarifications are documented.
10. Once all sections are completed, review the form for accuracy and completeness. Save changes, and you may download, print, or share the form as required.

Complete your Maryland Prenatal Risk Assessment form online today.