Fillable Form Proof of Pregnancy

What is a Proof of Pregnancy Letter?

A Proof of Pregnancy Letter is a formal document that confirms a person’s pregnant status. It is typically issued by a medical professional, such as an obstetrician, midwife, or general practitioner, and is often required by employers, insurance companies, and government agencies as proof of eligibility for pregnancy-related benefits and services.

The letter serves as evidence of the pregnancy and may include information such as the expected due date, any necessary accommodations or limitations for the woman's job or activities, and any anticipated medical expenses. It may also provide information about the medical professional providing the confirmation of pregnancy, including their name, title, and contact information, as well as their professional credentials and licensing or certification information.

How do I fill out a Proof of Pregnancy Letter?

A Proof of Pregnancy Letter requires information such as the name of the pregnant individual, the medical professional certifying the pregnancy, the gestational age of the fetus, and the estimated date of delivery as of the last checkup. Other, additional information may need to be added depending on the purpose for which the Proof of Pregnancy Letter will be used.

Date of Letter

Enter the date that the letter was written.

Date of Pregnancy Confirmation

Enter the date that the person’s pregnancy was confirmed.

Name of Pregnant Individual

Enter the name of the pregnant person.

Gestational Age of Fetus

Enter the gestational age of the fetus (in months and/or weeks as applicable) as of the time that this letter was written.

Estimated Date of Delivery

Enter the estimated date that the fetus will be delivered.

Additional Information

Add any relevant, additional information about the individual and their pregnancy here. If you require more space, use an appropriately labeled sheet of paper and attach it to this letter. You may also need to attach other documents related to the information you enter here in order to provide further evidence of or details on the information provided.

Name and Signature of Local Health Department Official

Enter the name of the medical professional and/or local health department official that is certifying the pregnancy, and have them sign the letter in the space provided. Then enter the date that the letter was signed.

Frequently Asked Questions (FAQs)

What do I need a Proof of Pregnancy Letter for?

Outside of its usefulness for medical professionals in recording and organizing your information for future care, the Proof of Pregnancy Letter is also useful for availing of things such as insurance policies, or when filing for maternity leave. Having a Proof of Pregnancy Letter can cut down the time needed to go through the process of receiving these kinds of benefits.

How is a pregnancy verified?

Usually, a pregnancy is confirmed first by a positive result on a pregnancy test. After receiving a positive pregnancy test, a second test may be administered directly by a medical professional to further confirm that the patient is, in fact, pregnant.

I’m experiencing common symptoms of pregnancy; do I still need to take a test?

You should still take a pregnancy test and set an appointment with an obstetrician or OB-GYN doctor for further tests. This is important so that you are absolutely sure that you are pregnant and can decide how to proceed accordingly.

Why is verification of pregnancy necessary?

Verifying that a person is pregnant ensures that they are not simply lying and using “pregnancy” as an excuse to get or avoid certain things that pregnant people are able to get or avoid.

Can I just write the letter myself using a positive result from an at-home pregnancy test?

No. While at-home pregnancy tests are more accurate now than ever, it is still important to get a health department officer or medical professional to verify that you are pregnant.

When do I have to submit a Proof of Pregnancy Letter?

The exact answer to this will depend on what you intend to use the letter for. In general, however, it is best to file anything that would require a Proof of Pregnancy Letter as soon as possible so that any complications or problems can be addressed at the soonest possible convenience.

What happens if I don’t submit a Proof of Pregnancy Letter?

You would likely cause issues in your ability to avail of any benefits that would otherwise be provided to you had you properly filed and submitted a Proof of Pregnancy Letter. It would also create difficulty for medical professionals, as they would lack a document that is an important part of your medical history.

Do I need to make a new Proof of Pregnancy Letter every time I get pregnant?

Yes, as there are many factors that could change between pregnancies, such as your health, your attending physician and the care that you need throughout your pregnancy. It is also necessary so that you can continue to avail of the services and benefits provided to expecting parents.

Can I write a Proof of Pregnancy Letter on behalf of my spouse/relative/friend and have a doctor sign it?

Provided that the doctor verified your spouse/relative/friend’s pregnancy and said acquaintance agrees to allow you to write the letter for them, yes. It may be beneficial to have the pregnant person that the letter is being written on behalf of to sign the form, as well, to show that they are aware and approve of your writing the letter and having it signed on their behalf.

What should I do if my employer refuses to accept my Proof of Pregnancy Letter?

If your employer refuses to accept your Proof of Pregnancy Letter, you should first try to understand their reasoning and communicate with them to see if the issue can be resolved. If you are not satisfied with the outcome, you may need to seek legal advice from an employment lawyer or file a complaint with the appropriate government agency.

Can I request a Proof of Pregnancy Letter for a previous pregnancy?

Yes. However, it is important to note that the information contained in a Proof of Pregnancy Letter may vary depending on the circumstances and the policies of the medical facility or provider. It may be best to check with the specific medical professional or facility that provided your prenatal care during your previous pregnancy to see if they are able to issue a Proof of Pregnancy Letter for that time period.

How long is a Proof of Pregnancy Letter valid?

It depends on what the letter is being used for. Generally speaking, however, a Proof of Pregnancy Letter is considered valid for the duration of a pregnancy, which is typically around 9 months.

What should I do if my Proof of Pregnancy Letter contains incorrect information?

If your Proof of Pregnancy Letter contains incorrect information, you should contact the medical facility or provider that issued the letter as soon as possible to request a correction. This may involve providing additional documentation or information to support the correction.

Can I have a Proof of Pregnancy Letter written in advance for when I actually get pregnant?

No. A Proof of Pregnancy Letter must be written for a current pregnancy, and cannot be provided for one that has not happened yet.

Do I need to file a new Proof of Pregnancy Letter every time I get pregnant?

Yes. This is because each pregnancy may have different circumstances and effects on your health, each of which need to be detailed in a Proof of Pregnancy Letter for the benefit of the pregnant individual, the healthcare provider, and the person or entity requesting that proof of pregnancy be provided.