Client information

Client Registration  This form gives us all the information we need to fill out the birth certificate.  It also gives us a health history for both you and your partner.  This information can help us to understand the uniqueness's within your pregnancy.

Parent Contract  This contract lays out expectations for payment, prenatal, postpartum and labor and delivery care.  You will find minimum requirements for hiring us for your pregnancy.

HIPAA Acknowledgement  Health Insurance Portability and Accountability forms ensures that each family understands their rights and privacy within the health industry.

Informed Consent  There are lots of test and screenings that happen during pregnancy.  This form lays out each test and gives us the opportunity to discuss each so that families can make an informed choice as to what is best for their situation.

Wisconsin Rules and Regulations  We are required to give this form to all of our clients.  This form gives each client a look into how the Licenced Midwife is allowed to practice.  It will show you the ins and outs of how we are allowed to practice as midwives.

Records Release Form  This form allows us to get all previous medical records from any place that you may have been in the past.

Additional Documents 

Over the Counter Medicine  This document has many different types of ailments that can occur in pregnancy.  The medicines listed for each are safe to use during pregnancy.

Herbs in Pregnancy This form has a list of herbs that can be helpful in pregnancy.  You will also find herbs to use with caution and herbs that you should avoid in pregnancy.

Healthy Choices in Pregnancy This document is a brief summary of the healthy food choices one can make in pregnancy.  It also discusses exercises, healthy weight gain and many other helpful tips for pregnancy.

Kegels are pelvic floor exercises that help to keep the muscles strong which in turn keep the pelvic organs in good health.

gena@tranquilitybirthservices.com

9909 Fairview Road Lancaster, WI 53813

608-723-3005

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