Pregnancy Verification Forms

Pregnancy Verification

A pregnancy verification form is a formal statement that confirms the pregnancy status of a woman. It is usually issued by a hospital or a medical authority to prove to any party that may want to know that a particular woman is, in fact, pregnant. It contains the date on which the pregnancy was confirmed, the estimated date on which delivery can be expected, a brief paragraph on the general health of the woman in question, and any additional comments that pertain to the pregnancy test itself. Keep in mind that a positive pregnancy test isn’t sufficient to get a doctor or a hospital to sign off on a pregnancy verification form – typically, they expect the woman to take a test in their presence to be sure, and also provide some identification.

How do I Verify Pregnancy Status?

There are a number of ways in which women may verify their pregnancy status. The most economical option includes a pregnancy test kit, which may be purchased at any medical or general store. All that needs to be done is simply following the steps at the back of the box, after which the kit will tell the woman if she is pregnant or not. These kits are, for the most part, extremely accurate and are clear indicators of pregnancy status. They are also very cheap and cost only $15 on average.

If this option doesn’t feel very decisive or safe, women can always set up an appointment with their local gynecologist or hospital. Here, the gynecologists are likely to conduct their own tests – blood and urine are commonly taken and tested for pregnancy indicators. This is a clear and Sureshot indicator of pregnancy status, making it preferable to many women. Additionally, the sentiment of trust between a woman and her personal gynecologist is likely to make such a test feel a little bit more decisive. Moreover, the gynecologist, upon request, will issue a pregnancy verification form that may be submitted as proof to any party that may require it. This commonly includes workplaces, courts, universities, etc.

How to Fill or Write a Pregnancy Verification Letter?

Drafting and filling out a pregnancy verification letter is a very straightforward process. It is a simple piece of documentation that has no legal jargon and just asks for some basic, personal information. Apart from that, it has a declaration at the end that is signed off by the physician. To help you out, we’ve compiled a sample pregnancy verification letter that you may take to get signed by your physician in case you need to! Our sample pregnancy verification letter can be found below;


Name _

Address _______________________________________________

Contact No. __

To whomsoever, it may concern,

The client, _ (Name) had conducted a pregnancy test in our presence. By our witness, we can confirm that her test, conducted on (Date of the test) has produced results that indicate a clear case of positive pregnancy. Based on vitals that include her menstruation period, blood patterns, and urine contents, we can estimate the date of delivery to be _ (estimated date of delivery.) Additionally, we also make the following observations;

(Here, the physician may add any additional details.)



Physician Name _

Hospital Name ___ Date __

Free Forms

Pregnancy Verification Letter Form

Sample Pregnancy Verification Form

Pregnancy Verification Form 01

Pregnancy Verification Form 02

Pregnancy Verification Form 03

Pregnancy Verification Form 04

Pregnancy Verification Form 05

Pregnancy Verification Form 06

Pregnancy Verification Form 07

Pregnancy Verification Form 08

Pregnancy Verification Form 09

Pregnancy Verification Form 10

Pregnancy Verification Form 11

Pregnancy Verification Form 12


What can be used as proof of pregnancy?

Women who are pregnant may obtain a pregnancy verification letter from a licensed physician or hospital. They will have to take a pregnancy test with the doctor or nurse as a witness or submit blood and urine samples for verification in the hospital/clinic’s labs. Once the pregnancy status is confirmed, the doctor will issue a signed statement declaring that the woman is pregnant. This serves as legal proof of pregnancy.

How do I show proof of pregnancy for Medicaid?

As we mentioned earlier, a licensed physical or medical entity may issue a pregnancy verification letter. This will serve as adequate proof of pregnancy for Medicaid, as well as for any other legal purpose.

Does Planned Parenthood give proof of pregnancy?

Typically, Planned Parenthood conducts free pregnancy tests. If there is a doctor present at the clinic, they may agree to sign off on a proof of pregnancy form. Keep in mind that a witness will be required for such a form, meaning women may not take positive pregnancy tests that have been used earlier to obtain a proof of pregnancy verification letter.

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