Date of Visit:
Name of Health Care Provider Seen:
Weeks of Pregnancy: Due Date:
Tests: (Check each one you had):
List any other tests you had:
(Turn to pages 8 and 9 for more information about tests.) Date of Next Appointment:
Other visits or problems since my appointment:
Problem Date Advice/Treatment
Your baby will grow quickly during the rest of your pregnancy. Your baby's size will put pressure on your bladder. You may need to go to the bathroom more often.
If you become constipated, drink more fruit juices and water and eat high fiber foods such as raw fruits and vegetables, whole grain breads, and cereals.
Call your health care giver right away if you have any of the signs of premature labor listed on page 12.
Questions I want to ask:
1. How can I find a pediatrician (baby doctor) or other
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