Preconception Health Assessment Form
Introduction parents2B
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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