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Preconception Health Assessment Form
Introduction 4 Providers

The Preconception Health Assessment tool is an opportunity for women to become better informed about their reproductive health status. This assessment tool is not intended to be diagnostic. Information obtained from the woman on the Preconception Health Assessment tool is confidential and will not used for any data gathering purpose by the Preconception Care Resource Center. An user identification and  password are only for the purpose of allowing a woman to return to her form as desired.

The information will be used to generate a Preconception Risk Assessment Report that is unique for each individual completing the tool. Both the Preconception Health Assessment tool and the Preconception Risk Assessment Report are intended to be used by the women and her health care provider in conjunction with a physical exam to formulate a preconception health plan specific to her and her partner.

The b4pregnancy.org web site offers primary care providers and their patients the most up to date information regarding preconception health issues. Also found on the web site are other assessment and charting tools, patient education materials, general and clinical information on topics specific to preconception care, online CME courses, and a state-wide database of South Carolina Board Certified physicians and advanced practice nurses who are committed to preconception health promotion. For more information contact Mary Boatwright, RN, MPH at (843) 852-3252.

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B4Pregnancy.org is made possible by a partnership between the South Carolina
March of Dimes and
the Department of Obstetrics and Gynecology at the  Medical University of South Carolina.

© Preconception Care Resource Center, Medical University of South Carolina, 1999.

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