Papers to bring with youAfter you make your first appointment with your midwife at CCBC, she will direct you to this page so you can read some important documents before your first appointment.

Please look at the list below to determine which documents are applicable to you. If you can, please print each one out so you can fill in the information before you come. Just bring the papers with you. But don’t worry if you don’t have a way to print these because we can also provide you with copies at the office. We just want you to have an opportunity to read them before you come and it does save time if you can fill in the information in advance of your appointment.

If you have any questions about this process, please just ask your midwife or call the office. We are looking forward to the opportunity to serve you. Click on the links below. If the file is a PDF, it will open in another window. You can then print them.  You will need to return to this page to open each new file.

Print the Contract for Services and bring it with you. Use the Discount If you have any questions about the contract, please feel free to ask us.

Contract for Services

Discounts Available

ALL new clients will need the following documents with them at their first visit. Please fill out and sign before coming.

Client Registration FORM

ER Back Up Plan

Routine Lab Tests Done by CCBC

Student Information Agreement

ALL Clients need an “Informed Choice Agreement” with each licensed midwife at our birth center.

Please print and bring with you an Informed Choice Agreement with the midwife. 

Beth Overton, CPM

Clients who have received care with another provider during this pregnancy will need to bring this form:

Authorization for Release of Medical Records

Clients who have insurance need the following:

Assignment of Insurance Benefits – In order for us to collect from your insurance company, we need this form filled out. 

Larsen Registration Instructions – Clients who have insurance are encouraged to register with Larsen Billing prior to their first appointment but no later than one week after. 

At CCBC we protect your privacy always! The following publication explains your rights:

Notice of Privacy Practice CCBC  (you do not have to print this unless you want a copy for yourself)