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ADVANCED OBSTETRICS & GYNECOLOGY, LLC Comprehensive Healthcare for Women PREGNANCY QUESTIONNAIRE PATIENT NAME: DATE OF BIRTH: / / 1. 2. 3. 4. 5. Will you be 35 or older when the baby is due? YES NO
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How to fill out genetic pregnancy questionnaire

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How to fill out a genetic pregnancy questionnaire:

01
Start by carefully reading the instructions provided with the questionnaire. This will give you an understanding of what information is required and how to provide it accurately.
02
Begin by providing your personal details, such as your name, age, address, and contact information. This will help the healthcare professionals to identify and communicate with you effectively.
03
Answer questions about your medical history. Genetic pregnancy questionnaires typically ask about any pre-existing medical conditions, previous pregnancies, and any history of genetic disorders within your family. Be honest and provide as much information as possible to ensure accurate assessment.
04
Answer questions about your partner's medical history. If applicable, provide information about your partner's medical background, including any genetic disorders or conditions that may be relevant.
05
Follow the instructions on providing information about your current pregnancy. This may include the estimated due date, number of pregnancies, any complications experienced, and any prenatal testing already done.
06
Be prepared to answer questions about your lifestyle habits. Some questionnaires may ask about your smoking or drinking habits, drug use, and exposure to environmental hazards. Provide truthful answers to help healthcare professionals assess potential risks accurately.
07
In case you have undergone any genetic testing during your pregnancy, provide the results and details of these tests. This includes any ultrasound scans, blood tests, or genetic screenings that have been done.
08
Finally, review your answers before submitting the questionnaire. Double-check for any mistakes or omissions to ensure that all the information provided is accurate.

Who needs a genetic pregnancy questionnaire?

01
Couples who are planning to conceive or are already pregnant may be required to fill out a genetic pregnancy questionnaire. It helps healthcare professionals assess the risk of genetic disorders or inherited conditions in the unborn child.
02
Individuals with a family history of genetic disorders or conditions may also be advised to fill out a genetic pregnancy questionnaire. This allows healthcare professionals to understand the potential risks and provide appropriate guidance.
03
Those who have experienced previous pregnancies with genetic abnormalities may be asked to complete a genetic pregnancy questionnaire. This helps in identifying any underlying factors that may have contributed to the genetic condition.
04
Healthcare providers may suggest filling out a genetic pregnancy questionnaire for pregnant women who are above a certain age, as the risk of genetic abnormalities increases with maternal age.
Overall, anyone who wants to assess their risk of having a child with a genetic disorder or wants to gain a better understanding of their genetic background during pregnancy can benefit from filling out a genetic pregnancy questionnaire. It helps healthcare professionals make informed decisions and provide appropriate care.
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