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What Is Texas Proof of Pregnancy Form H3037?
Form H3037 should be filled to report pregnancy from the sixth to the ninth month. The advisor should give an original and two copies to the individual. If the client works with a physician, an original and a copy has to be sent to the medical worker first, who will provide a self-return mail.
What I Need the Proof of Pregnancy Form Texas for?
- If the client should get official permission to be exempt from working. That’s why Proof of Pregnancy Form Texas should be filled out only if the pregnancy began at least six months ago;
- to report about the date of the expected delivery;
- to report if the client will have multiple births;
- to get official Proof of Pregnancy Form from a doctor.
How to Fill Out Texas Proof of Pregnancy Form H3037?
Printable Proof of Pregnancy Form PDF consists of two pages. You should follow these steps to fill out this blank.
- Write the name of the patient and their case name and number;
- Fill out the information about the pregnancy, including the month when the pregnancy began and the expected date of delivery;
- Indicate the information about the physician or other medical worker. You should write the name, address, and telephone number;
- Section “Please return to” should contain the address where the physician has to return this form after signing.
You don’t need to sign the fillable proof of pregnancy document when it’s ready; it should be done by the medical worker.
Where to Get Form H3037 for Texas
If an employee is pregnant, and she needs to request an accommodation, she will need to provide documentation of pregnancy. This is usually provided by an obstetrician and is sometimes called a "letter of accommodation."
If the letter of accommodation is not provided by the employee's obstetrician, the form H3037 report of pregnancy must include:
- The employee's name and her date of birth;
- The date the pregnancy began;
- The expected date of delivery;
- The type of pregnancy (singleton, twins, etc.);
- The obstetrician's name, address, and telephone number; and
- The obstetrician's signature.
Pregnancy documentation may also be provided by a midwife, certified nurse midwife, or physician's assistant.
If the employee is not pregnant, she may provide documentation from any other health care professional who is qualified to diagnose her medical condition. This documentation should state that the employee's medical condition meets the definition of a disability under the ADA.
A proof of pregnancy form template is available at PDFLiner.
Organizations That Work With Texas Verification of Pregnancy Form H3037
Texas Health and Human Services Commission.
FAQ: Texas Verification of Pregnancy Letter Popular Questions
Who should create a pregnancy verification letter?
A pregnancy verification letter should be created by a medical professional that has examined the pregnant woman to confirm the pregnancy. For example, a doctor, nurse, or midwife.
Where to get proof of pregnancy form H3037 in Texas?
The H3037 form is available from the Texas Department of Health and Human Services or here at PDFLiner. If you are a qualified professional, you can also get the form in your medical office. If you need a form H3037 for yourself or a family member, please contact your nearest Texas Department of Health and Human Services office.
How to create a confirmation of pregnancy letter?
There is no one definitive answer to this question. However, some tips on how to create a pregnancy confirmation letter may include including information such as the date of the last menstrual period, the expected date of delivery, the number of weeks of pregnancy, and the name and contact information of the healthcare provider. Additionally, it is important to make sure that the letter is clear and concise, and free of any grammar or spelling errors.
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Fillable online Texas Proof of Pregnancy Form H3037