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Date Received by Enrollment School: ___APPLICATION FOR INSTRUCTIONAL PROGRAM FOR HOUSEBOUND OR HOSPITALIZED STUDENTS HOME AND HOSPITAL PROGRAM Baltimore County Public Schools 6229 Falls Road, Baltimore,
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Gather all relevant information such as medical history, current medications, and any previous pregnancies.
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Complete all sections of the form accurately and thoroughly, including personal information, obstetric history, and current pregnancy details.
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Provide any necessary documentation or medical records to support the information provided on the form.
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Review the completed form for any errors or missing information before submitting it.

Who needs physicalpregnancy professional statement?

01
Pregnant women who are seeking prenatal care from a healthcare provider.
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Healthcare professionals who are providing prenatal care and need a comprehensive overview of the patient's medical history and current pregnancy status.
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The physicalpregnancy professional statement is a document that outlines the health status of a pregnant woman and any necessary accommodations or restrictions related to her job.
Pregnant women who are currently employed and need accommodations or restrictions related to their job are required to file a physicalpregnancy professional statement.
To fill out the physicalpregnancy professional statement, the pregnant woman must provide detailed information about her health status, any limitations or accommodations needed, and any recommendations from her healthcare provider.
The purpose of the physicalpregnancy professional statement is to ensure that pregnant women receive the necessary accommodations and support in the workplace to protect their health and the health of their baby.
The physicalpregnancy professional statement must report the pregnant woman's health status, any limitations or accommodations needed, and recommendations from her healthcare provider.
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