Serving the needs of Salida, Saguache, and Coaldale Colorado

Prenatal Care at Salida Family Medicine

Dear Expectant Mother,

We are pleased and excited you have chosen us to help care for you during this very special time in your life. Our number one priority is for you to have a safe, happy pregnancy as well as a memorable delivery with thorough postnatal care, and informative and comprehensive care for your newborn. Our physicians and clinical staff are here to support you through the upcoming months and beyond.

In this packet, you will find a personal history form to complete, as well as some additional information to review and sign. Just bring the completed packet with you to your upcoming appointment.

Prenatal Instructions
Over the Counter Medications

Forms for reading and downloading

• New Patient Information Form (pdf format) - download and fill out
• New Patient Payment Form (pdf format) - download and fill out
• Notice of Privacy Practices
• Acknowledgement of Receipt of Privacy Notice (pdf format) - please download and fill out
• Authorization to Release Protected Health Information/Records  (pdf format) - please download and fill out
• Prenatal Blood Test Request  (pdf format) - please download and take to Heart of the Rockies Regional Medical Center
• Pregnancy and Medication Risks (pdf format) - please download and fill out
• Salida Family Medicine Financial Policy (pdf format) - please download and fill out
• Obstetrical Care Financial Agreement  (pdf format) - please download and fill out
• Prenatal Data Base Questionnaire (pdf format) - please download and fill out

We look forward to seeing you, and welcome to our practice!