Client Code:CDP615
CDP Data Collection Form
Priority Medicaid Populations (check all that apply): - Medically high risk
- Limited/No family support
Date of Referral: 07/07/2021
Doula: Ellen Tappon
Meet and Greet Date: 07/13/2021
Method: Phone
Date of 1st Prenatal: 08/23/2021
1st Prenatal Attended By: Client, Doula
Location of 1st Prenatal: Avry Park
Time: 2
Notes:
Discussed general and pregnancy physical, mental and oral health, Past pregnancies, births and postpartum experiences, relationship with provider, past/current experiences that might impact birth, Breastfeeding, support needs, Healthy Families referral, Pollywog info. Sent info on COVID vaccine in pregnancy, diabetes in pregnancy, C-section, Big Babies, Physical therapists and chiropractors for pregnancy that take IHN, WIC, Breastfeeding, advanced maternal age,