Late Pregnancy Prenatal Appointment Checklist Form
Use this checklist to prepare for your upcoming late-pregnancy prenatal visit. Complete each item to ensure you have everything you need for your appointment.
Appointment Date and Time
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Bring a valid photo ID
I will bring my photo ID
Bring your insurance card (if applicable)
I will bring my insurance card
Prepare a list of questions or concerns for your provider
I have prepared my questions/concerns
Bring your current medication list
I will bring my medication list
Pack a copy of your birth plan (if you have one)
I will bring my birth plan
Arrange for a support person to accompany you (if desired)
I have arranged for a support person
Bring snacks and water for your comfort
I will bring snacks and water
Wear comfortable clothing for your appointment
I will wear comfortable clothing
Bring your prenatal vitamins (if requested by your provider)
I will bring my prenatal vitamins
Bring any required forms or paperwork
I will bring necessary forms/paperwork
Submit Checklist
Should be Empty: