Fillable Form Pregnancy Verification Letter

What is the Pregnancy Verification Letter?

The Pregnancy Verification Letter is a document that acts as proof that a patient is pregnant. It may also include details on the patient’s medical history and other complications or factors that may affect their pregnancy.

The letter will generally be filled out or written and signed by a local health department official or another medical professional, such as an Obstetrics and Gynecology doctor (OB-GYN), for the use of the person or people requesting it and other medical professionals. Oftentimes, the letter will be provided (either automatically or by request) after the health department official or medical professional is able to confirm that the patient is pregnant.

There are many different reasons for why a pregnancy must be verified by a medical professional, all differing between different contexts and situations. Most often, the verification form will be used for clinical or medical purposes, to record the status of a patient with regards to their pregnancy. Other details will often be included in a Pregnancy Verification Letter, such as the patient’s and the fetus’s health, particular needs when it comes to care, and even scheduled appointments for checkups and an estimated date of when the fetus will be born. 

The Letter may be updated with new information as the patient’s pregnancy progresses and more appointments need to be scheduled or other treatment options arranged, or it may be added to another file that contains all information needed by medical personnel to administer care to the patient. In either case, it is important to keep the letter in a safe place to ensure that it is always available whenever it needs to be updated or used for any purpose. 

Insurance companies, employers, and particular services will also often ask for a Pregnancy Verification Letter in order to avail of particular benefits or services that are either only available for pregnant persons or will grant pregnant people priority when it comes to queues, similar to a Disability ID or a Senior Citizen ID. 

Pregnancy is a very significant and risky status for a mother-to-be, due to the impact it has on the mother’s health. It is advisable to begin preparing for it as soon as possible. By verifying a pregnancy at the earliest possible opportunity, more time will be available to consult medical professionals on how to proceed with the pregnancy and keep both the mother and the baby healthy before, during, and after birth.

How do I fill out the Pregnancy Verification Letter?

The Pregnancy Verification Letter is requires information such as the patient’s full legal name and various dates relevant to the verification of your pregnancy and expected delivery date. The longest part of the letter will likely be the “additional information” section, but this should not be any cause for concern as most information here should be provided by the health department official or medical professional that is verifying the pregnancy. 

Step 1: Date

Enter the date (day, month, and year) that the Pregnancy Verification Letter is written or filled out in the spaces provided. 

Step 2: Name of Patient

Enter the full legal name of the person whose pregnancy is being verified. Do not use any abbreviations or nicknames.

Step 3: Gestational Age of Fetus

Enter the gestational age (how far along the pregnancy is) of the fetus at the time that this letter was filled out.

Step 4: Estimated Date of Delivery

Enter the estimated date of delivery (childbirth) in the space provided. 

Step 5: Additional Information

Enter any additional information that may be relevant to the pregnancy (or any other actions that must be taken because of or for it) here. Information such as the method by which the pregnancy was verified and particular concerns about the pregnancy and the patient’s health should be put here. Consult a medical professional to determine what information should be included here, and make sure to put everything that the medical professional states is important to note down. Use a separate sheet of paper (labeled appropriately) as necessary.

Step 6: Signature of Health Department Official

Have the health department official (or medical professional) that verified the patient’s pregnancy sign the letter in the space provided. Then enter the date that the letter was signed. 

Frequently Asked Questions (FAQs)

What do I need a Pregnancy Verification Letter for?

Outside of its usefulness for medical professionals in recording and organizing your information for future care, a Pregnancy Verification Letter is also useful for availing of things such as insurance policies, or when filing for maternity leave. Having a Pregnancy Verification Letter can cut down the time needed to go through the process of receiving these kinds of benefits.

How is a pregnancy verified?

Usually, a pregnancy is confirmed first by a positive result on a pregnancy test. After receiving a positive pregnancy test, a second test may be administered directly by a medical professional to further confirm that the patient is, in fact, pregnant.

I’m experiencing common symptoms of pregnancy; do I still need to take a test?

You should still take a pregnancy test and set an appointment with an obstetrician or OB-GYN doctor for further tests. This is important so that you are absolutely sure that you are pregnant and can decide how to proceed accordingly.

Why is verification of pregnancy necessary?

Verifying that a person is pregnant ensures that they are not simply lying and using “pregnancy” as an excuse to get or avoid certain things that pregnant people are able to get or avoid. 

Can I just write the letter myself using a positive result from an at-home pregnancy test?

No. While at-home pregnancy tests are more accurate now than ever, it is still important to get a health department officer or medical professional to verify that you are pregnant. 

When do I have to submit a Pregnancy Verification Letter?

The exact answer to this will depend on what you intend to use the letter for. In general, however, it is best to file anything that would require a Pregnancy Verification Letter as soon as possible so that any complications or problems can be addressed at the soonest possible convenience.

Are there any requirements needed as part of writing or submitting a Pregnancy Verification Letter?

There are no requirements involved in the writing of a Pregnancy Verification Letter aside from the signed acknowledgement of a medical professional. 

Is there a penalty for not having a Pregnancy Verification Letter?

Not technically, though it would present great difficulty for you when filing for things such as health insurance or maternity leave, as there would be no document to serve as proof that you are actually pregnant. It would also make it difficult for medical professionals to determine or record what kind of care should be provided to you over the course of your pregnancy.

Do I need to make a new Pregnancy Verification Letter every time I get pregnant?

Yes, as there are many factors that could change between pregnancies, such as your health, your attending physician and the care that you need throughout your pregnancy. It is also necessary so that you can continue to avail of the services and benefits provided to expecting parents.

What is Maternity Leave?

Maternity Leave is a type of leave that is granted to birthing parents before and after giving birth. Maternity Leave generally lasts for about 12 work weeks (3 months), and may be paid or unpaid depending on the employer. Different states have different laws that can sometimes affect Maternity Leave, so it is also beneficial to check your state’s laws around it to be sure.

What does an Obstetrician or OB-GYN do?

Obstetricians and OB-GYN doctors specialize in the field of obstetrics, which concerns pregnancy, childbirth, and post-childbirth. They monitor and administer or recommend care for pregnant people and will often cooperate with other fields of medicine to ensure that their patients receive the care they need during their particular stage of childbirth or post-childbirth. 

Can I write a Pregnancy Verification Letter on behalf of my spouse/relative/friend and have a doctor sign it?

Provided that the doctor verified your spouse/relative/friend’s pregnancy, yes. It may be beneficial to have the pregnant person that the letter is being written on behalf of to sign the form, as well, to show that they are aware and approve of your writing the letter and having it signed on their behalf.

Where do I find an Obstetrician or OB-GYN?

Call your local hospital or health department for information on where the closest practicing obstetrician or OB-GYN is, and what times they are most likely to be available to schedule an appointment.

How is the estimated date of delivery determined?

Estimated date of delivery is calculated based on a person’s last menstrual period. The exact steps are as follows:

 

1. Determine the first day of the patient’s last menstrual period.
 

2. Count back 3 calendar days from that date.
 

3. Add 1 year and 7 days to that date.
 

Note that this method is based on a regular, 28-day menstrual cycle, and as such may need to be adjusted if the patient’s last menstrual period was longer or shorter than that. It would be best to ask your doctor for assistance in estimating the date of birth.

How accurate is the estimated date of delivery?

Not very accurate. Only about 6% of patients deliver on the estimated date, with about 70% delivering the baby within 10 days (before or after) their estimated due date. Providing an estimated date of delivery is there simply so that a general time frame can be constructed regarding the patient’s pregnancy.