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Dear Physician: We are requesting that you please complete this Obstetrical Notification form for the obstetrical services of this patient. Please
mail or fax this information to the address indicated above or via fax 305-384-7059. This information must be received two days prior to the
patient’s next prenatal visit appointment (weekends and holidays excluded).
Initial Physical Exam:
Please see the attached Routine Pre-Natal Care Guidelines expected for this patient, for an outline of the routine prenatal visits, labs and
documentation required during pregnancy period. All guidelines are based on the practice and recommendations for routine prenatal care
as stated by the American College of Obstetrics and Gynecology ACOG, and the American Academy of Family Physicians AAFP.
Kindly refer patient for any diagnostic laboratory, ultrasound or for the purposes of delivery to a participating provider. For information on
participating providers please call 305-760-8739.
All bills will be processed following CPT code guidelines and Correct Coding Initiative rules. Please make sure to use current CPT codes and
ICD10-CM for claims in order to avoid delays in payment. For all billing questions, please call 305-760-8739.