Get Mihs Maternity Package

Filling out the Mihs Maternity Package form is an essential step for expecting parents in Maricopa County to secure comprehensive prenatal maternity care. This guide will assist you through each section of the form, ensuring a smooth and straightforward process.

Follow the steps to complete the Mihs Maternity Package form effectively.

1. Click ‘Get Form’ button to obtain the Mihs Maternity Package and open it in the online editor.
2. Provide your personal information including your name, policy number, date of birth (DOB), patient ID (PID), estimated due date (EDD), account number, term date, and effective date. Ensure all details are accurate.
3. Indicate your down payment in the space provided. Enter the amount as instructed.
4. Read the eligibility requirements carefully. Confirm you meet the requirement by initialing adjacent to the statement that affirms your residency in Maricopa County.
5. In the section titled 'Prenatal Care Services,' select your preferred clinic from the list provided. Initial next to your choice.
6. Review the delivery options available. For each option, initial to confirm your selection and understand the payment terms, including full payments or payment within 90 days.
7. Acknowledge the exclusion of certain services by reading and initialing the section that outlines what is not covered under this agreement.
8. Complete the agreement section by initialing each statement, showing your understanding of all terms, conditions, and further responsibilities.
9. After completing all sections, review the entire form to ensure accuracy and completeness.
10. Finally, save the changes to the form, then download or print your completed document for your records.

Complete your Mihs Maternity Package form online to secure your maternity care today.