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     Phone 1-888 MEDSEEK. email info@medseek.com. http://www.medseek.com 
     (c) 1999-2006 Medseek, Inc. All rights reserved.-->
    









	
	
	 
	 
	 
	 

	
	
	
	

	
	

	
	

	
	

	
	

	
	

	
	


	
	

	
	

	
	
	
	
	

	
	

	
	

	
	

	
	

	
		
		
	
		

	
		

	
		

	
		

	 
	 
	 
	 

	
	
	
	
	
	
	
		
	

	
	 
	
	
	
	
	
	

	
	
	
	
	

	
	

	
	

	
	

	
	

	
	

	
	

	
	

	
	

	
	

	
	

	
	

	
	
	
	
	
	
	
	
	
	

	
	

	
	

	
	

	
	

	
	

	
	

	
	

	
	

	
	

	
	

	
	

	
	
	
	

	
	

	
	

	
	

		
	
	
	
	
	
	
	
	
	
	

	
	

	
	

	

	
	

	
	

	
	

	
	

	
	

	
	
	
	
	

	
	

	
	

	
	

	
	

	
	

	
	

	
	

	
	

	
	

	
	

	
	

	
	

	
	

	
	

	
	
	
	
	

	
	

	
	

	
	

	
	

	
		
		
	
		

	
		

	
		

	
		
	
	
		
		
	
		
	
	
		
	
	
	
		
	
	
	
	
	
	
	
	

	
	
	
	
		
		
			

		
		
		
		
		
		
		
		
		
		
		
		
		
		

		
			
		
		 
		
		
		
		

		
		
		
		
		
		
		
		
		
		

		
		
		
		

		

		
		
		

			
				
			
		
		
		
		
		

		
		
		
		
		
		
		
			

		
		
		
		
				
		
		
		
				
		
			
		

		
		
		
		
		
		
	
		
			
			
			
		
		
		
	
		
			
			
		

		
		
		
		
			

		

		
		
		

			
				
			
		
		
		
		
		

		
		
		
		
		
		

		
					
						
		
		
				
		
		
		
		
		
				
		
		

		
		
		
		
		
		
		
		
			
			
				
			
		
		
		
		
		
			
			
		
		
		
		
		
			
			
		

		
		
		
			
			
		
		
		

		
			

			
		
		

		
		

		
				
		 
		
			
		
		
		

		
			
			
		
		
		
			

		

		
		
		
		

		
		

		
		
		
		
		
		
		
		
		
		

		
		
		
	
	
	



	
	
	
	
	
	
	
	
	
	
	
	
	
	


	
	
		
			
		
	
	
	
	
	
		
			
		
	
	
	
	
	

 

	
	
	
		



		
		
		
		
		
		
		
		
		
		
		
		
		
		
		
		
		
		
		
		

		
		

		
		
		
		

		

		
		
		

			
				
			
		
		
		
		
		

		
		
		
		
		
		
		
			

		
		
		
		
				
		
		
		
				
		
			
		

		
		
		
		
		
		
	
		
			
			
			
		
		
		
	
		
			
			
		

		
		
		
		
			

		

		
		
		

			
				
			
		
		
		
		
		

		
		
		
		
		
		

		
					
						
		
		
				
		
		
		
		
		
				
		
		

		
		
		
		
		
		
		
		
			
			
				
			
		
		
		
		
		
			
			
		
		
		
		
		
			
			
		

		
		
		
			
			
		
		
		

		
			

			
		
		

		
		

		
				
		 
		
			
		
		
		

		
			
			
			
		
		
			

		

		
		
		
	
		

		
		

		
		
		
		
			
		
		
		
			

		
		

		
		

		
		
		
		
		
		
		
			
				

		
		
		
		

		

		
		
		

			
				
			
		
		
		
		
		

		
		
		
		
		
		

		
		
		
		
				
		
		
		
				
		
			
		

		
		
		
		
		
		
	
		
			
			
			
		
		
		
	
		
			
			
		

		
		
		
		
			

		

		
		
		

			
				
			
		
		
		
		
		

		
		
		
		
		
		

		
					
						
		
		
				
		
		
		
		
		
				
		
		

		
		
		
		
		
		
		
		
			
			
				
			
		
		
		
		
		
			
			
		
		
		
		
		
			
			
		

		
		
		
			
			
		
		
		

		
			

			
		
		

		
		

		
				
		 
		
			
		
		
		

				
			
		
		

		
		
		
		
			

		
		

		
		

		
		
		
		
		
		
		
		

		
		
		
		
		
		
			

		
		

		
		

		
		
		
		
		
		
		
			
				

		
		
		
		
		
		
		
		
		
		
		
		
		
		

		
			
		
		 
		
		
		
		

		
		
		
		
		
		
		
		
		
		

		
		
		
		

		

		
		
		

			
				
			
		
		
		
		
		

		
		
		
		
		
		
		
			

		
		
		
		
				
		
		
		
				
		
			
		

		
		
		
		
		
		
	
		
			
			
			
		
		
		
	
		
			
			
		

		
		
		
		
			

		

		
		
		

			
				
			
		
		
		
		
		

		
		
		
		
		
		

		
					
						
		
		
				
		
		
		
		
		
				
		
		

		
		
		
		
		
		
		
		
			
			
				
			
		
		
		
		
		
			
			
		
		
		
		
		
			
			
		

		
		
		
			
			
		
		
		

		
			

			
		
		

		
		

		
				
		 
		
			
		
		
		

		
			
			
		
		
		
			

		

		
		
		
		

		
		

		
		
		
		
		
		
		
		
		
		

		

		

		
		
		
		
		
		
		
		
		
		
		
		

		
			
		
		

		
		
		
		


		
			

		

		
		
		

	
		
		
		
		

		



		
		

		
		
		
		
		

		
		
		
		

		

		
		
		

			
				
			
		
		
		
		
		

		
		
		
		
		
		
		
			

		
		
		
		
				
		
		
		
				
		
			
		

		
		
		
		
		
		
	
		
			
			
			
		
		
		
	
		
			
			
		

		
		
		
		
			

		

		
		
		

			
				
			
		
		
		
		
		

		
		
		
		
		
		

		
					
						
		
		
				
		
		
		
		
		
				
		
		

		
		
		
		
		
		
		
		
			
			
				
			
		
		
		
		
		
			
			
		
		
		
		
		
			
			
		

		
		
		
			
			
		
		
		

		
			

			
		
		

		
		

		
				
		 
		
			
		
		
		

		
			
			
		
		
		

		
		
		
		

		

		
		
		

			
				
			
		
		
		
		
		

		
		
		
		
		
		
		

		
		
		
		
				
		
		
		
				
		
			
		

		
		
		
		
		
		
	
		
			
			
			
		
		
		
	
		
			
			
		

		
		
		
		
			

		

		
		
		

			
				
			
		
		
		
		
		

		
		
		
		
		
		

		
					
						
		
		
				
		
		
		
		
		
				
		
		

		
		
		
		
		
		
		
		
			
			
				
			
		
		
		
		
		
			
			
		
		
		
		
		
			
			
		

		
		
		
			
			
		
		
		

		
			

			
		
		

		
		

		
				
		 
		
			
		
		
		

		
		
		

		
		

		
		

		
		
		
		
		
		
		
			
				
				

				
				

		
		
		
		

		

		
		
		

			
				
			
		
		
		
		
		

		
		
		
		
		
		

		
		
		
		
				
		
		
		
				
		
			
		

		
		
		
		
		
		
	
		
			
			
			
		
		
		
	
		
			
			
		

		
		
		
		
			

		

		
		
		

			
				
			
		
		
		
		
		

		
		
		
		
		
		

		
					
						
		
		
				
		
		
		
		
		
				
		
		

		
		
		
		
		
		
		
		
			
			
				
			
		
		
		
		
		
			
			
		
		
		
		
		
			
			
		

		
		
		
			
			
		
		
		

		
			

			
		
		

		
		

		
				
		 
		
			
		
		
		

				
			
		
		

		
		
		

		


 

		
	
	
	
		





















 

	

 
























		
		
		
		
		
		
		
		
		
		
		
		
		
		

		
			
		
		 
		
		
		
		

		
		
		
		
		
		
		
		
		
		

		
		
		
		

		

		
		
		

			
				
			
		
		
		
		
		

		
		
		
		
		
		
		
			

		
		
		
		
				
		
		
		
				
		
			
		

		
		
		
		
		
		
	
		
			
			
			
		
		
		
	
		
			
			
		

		
		
		
		
			

		

		
		
		

			
				
			
		
		
		
		
		

		
		
		
		
		
		

		
					
						
		
		
				
		
		
		
		
		
				
		
		

		
		
		
		
		
		
		
		
			
			
				
			
		
		
		
		
		
			
			
		
		
		
		
		
			
			
		

		
		
		
			
			
		
		
		

		
			

			
		
		

		
		

		
				
		 
		
			
		
		
		

		
			
			
		
		
		
			

		

		
		
		
		

		
		

		
		
		
		
		
		
		
		
		
		

		


		
		
		
		
		
		
		
		
		
		
		
		
		
		

		
			
		
		 
		
		
		
		

		
		
		
		
		
		
		
		
		
		

		
		
		
		

		

		
		
		

			
				
			
		
		
		
		
		

		
		
		
		
		
		
		
			

		
		
		
		
				
		
		
		
				
		
			
		

		
		
		
		
		
		
	
		
			
			
			
		
		
		
	
		
			
			
		

		
		
		
		
			

		

		
		
		

			
				
			
		
		
		
		
		

		
		
		
		
		
		

		
					
						
		
		
				
		
		
		
		
		
				
		
		

		
		
		
		
		
		
		
		
			
			
				
			
		
		
		
		
		
			
			
		
		
		
		
		
			
			
		

		
		
		
			
			
		
		
		

		
			

			
		
		

		
		

		
				
		 
		
			
		
		
		

		
			
			
		
		
		
			

		

		
		
		
		

		
		

		
		
		
		
		
		
		
		
		
		

		


		
		
		
		
		
		
		
		
		
		
		
		
		
		

		
			
		
		 
		
		
		
		

		
		
		
		
		
		
		
		
		
		

		
		
		
		

		

		
		
		

			
				
			
		
		
		
		
		

		
		
		
		
		
		
		
			

		
		
		
		
				
		
		
		
				
		
			
		

		
		
		
		
		
		
	
		
			
			
			
		
		
		
	
		
			
			
		

		
		
		
		
			

		

		
		
		

			
				
			
		
		
		
		
		

		
		
		
		
		
		

		
					
						
		
		
				
		
		
		
		
		
				
		
		

		
		
		
		
		
		
		
		
			
			
				
			
		
		
		
		
		
			
			
		
		
		
		
		
			
			
		

		
		
		
			
			
		
		
		

		
			

			
		
		

		
		

		
				
		 
		
			
		
		
		

		
			
			
		
		
		
			

		

		
		
		
		

		
		

		
		
		
		
		
		
		
		
		
		

		


	




	<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 3.2 Final//EN">
	<HTML>






	<HEAD>
	<TITLE>Find a Form</TITLE>
	<meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1">
	<meta name="description" content="">
	<meta name="keywords" content="Refferal physician, San Jose, Obstetrix, Patient registration, Genetic counseling, Diabetes, Medical record , OB history, new patient registration">
	<style type="text/css">
		@import url(default.css);
	</style>
	
	
            <script language="JavaScript" type="text/javascript">
            <!--//
                  var ns4 = (document.layers);
                  var ie  = (document.all);
                  var ie4 = (ie && !document.getElementById);
                  var ie5 = (ie && document.getElementById);
                  var ns6 = (!ie && document.getElementById);
   
						var aryMoused = new Array();
						var aryLayerMoused = new Array();
						var aryMoImages = new Array();
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						var runMouseOvers = true;
						var TimerID = null;
						var iLimit = 25;
						var itmp = 0;
						
						var nbTime = 100;
						var nbTimes = 2;
						var nbThisLoc = 325;
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						var aryNavBarLayerInfo = new Array();
						var aryNavBarLayers = new Array();
						
						var registeredObjects = new Array();
						var viz = "hide";

						function MOImage() {
							var arg = MOImage.arguments;
							this.ptrImage = BillzNavBarMM_findObj(arg[0]);
							this.imageMO = new Image();
							this.imageMO.src = arg[1];
							this.HTMLname = arg[0];
							this.Moused = false;
							this.OriginalSrc = '';
							return true;
						}
						function BillzImagePreload() {
						// 0) html image name 1) mo image src 2)image Name for rollover key (rollover may have multiple mos for one html Image) 
							var arg = BillzImagePreload.arguments;
							nbImagePreload(arg[0], arg[1], arg[2]);
						}
                  function nbImagePreload(img_name, mo_img_src, rollover_key_img_name)
                  {
                     var imageKey = (rollover_key_img_name.length > 0) ? rollover_key_img_name : img_name;
							imageList[imageList.length] = imageKey;
							if (!(aryMoImages[imageKey])) {
								aryMoImages[imageKey] = new MOImage(img_name, mo_img_src);
							}
                  }
                  
						function BillzMouseover() {
							var arg = null;
							if (runMouseOvers) {		
								arg = BillzMouseover.arguments; //args 0)ImageName 1)OriginalSrc 2)array index (caller imagename)		
								nbMouseover(arg[0], arg[1], arg[2]);
							}
							return true;
						}
                  // args 1) ImageName 2) OriginalSrc 3) array index (caller imagename)
                  function nbMouseover(img_name, orig_src, img_key)
                  {
							var imageKey = null;
							var o = null;
							if (runMouseOvers) 
                     {				
								imageKey = (img_key.length > 0) ? img_key : img_name;
								if (!(aryMoImages[imageKey].ptrImage)) {
									aryMoImages[imageKey].ptrImage = BillzNavBarMM_findObj(img_name);
								}
								if (aryMoImages[imageKey] && (o = aryMoImages[imageKey].ptrImage)) 
                        {
									aryMoImages[imageKey].OriginalSrc = orig_src;
									aryMoImages[imageKey].Moused = true;
									o.src = aryMoImages[imageKey].imageMO.src;
								}
							}
							return true;
                  }
                  
						var NavBarTempOnload = null;
						if (window.onload && window.onload != null){
							NavBarTempOnload = window.onload;
						}
						function FullyLoaded() {
							if (NavBarTempOnload != null){
								NavBarTempOnload();
							}
							runMouseOvers = true;
							return true;
						}
						function BillzMouseOutTimer() {
							return nbMouseOutTimer();
						}
                  function nbMouseOutTimer() 
                  {
							if (TimerID) {
								clearTimeout(TimerID);
							}
							TimerID = setTimeout("nbLayerRestore()",5000);
							return true;
						}
						function RestoreAll() {
							nbMouseoverRestore();
							nbLayerRestore();
							return true;
						}
                  
						function BillzMouseoverRestore() {
							return nbMouseoverRestore();
						}
                  function nbMouseoverRestore() 
                  {
							var i = 0;
							var o = null;
							if (runMouseOvers) 
                     {
								for (i = 0; i < imageList.length; i++) 
                        {
									if (aryMoImages[imageList[i]].Moused && (o = aryMoImages[imageList[i]].ptrImage)) 
                           {
										o.src = aryMoImages[imageList[i]].OriginalSrc;
										aryMoImages[imageList[i]].Moused = false;
									}
								}
							}
							return true;
						}
                  
						function BillzLayerRestore() {
							return nbLayerRestore();
						}
                  function nbLayerRestore() 
                  {
							var i = 0;
							for (i = 0; i < aryLayerNames.length; i++) 
                     {
								if (!aryNavBarLayerInfo[aryLayerNames[i]].isDefault) {
									BillzNavBarRestoreLayers(aryLayerNames[i]);
								}
							}
							return true;
						}

						function BillzArrayPushUnique(aryArray, varNewElement) { //only pushes if unique value
							var pushIt = true;
							var i = 0;
							for (i = 0; i < aryArray.length && pushIt; i++) {
								pushIt = (varNewElement != aryArray[i]);
							}
							if (pushIt) {
								BillzArrayPush(aryArray, varNewElement);
							}
							return pushIt;
						}
						function BillzArrayPush(aryArray, varNewElement) { //Implement Array Push 'cause IE cant handle it
							aryArray[aryArray.length] = varNewElement;
							return true;
						}
						function BillzArrayPop(aryArray) { //Implement Array Pop 'cause IE cant handle it before 5.5
							var varItemToPop = null;
							if (aryArray[aryArray.length - 1]) {
								varItemToPop = aryArray[aryArray.length - 1];
								aryArray[aryArray.length] = null;
							}
							return varItemToPop;
						}
			                 
                  //v3.0 name changed to avoid clash with possible other JS in content, this function complements of MM Dreamweaver
						function BillzNavBarMM_findObj(n, d) {
						  	var p,i,x;
						
							if (registeredObjects[n]) {
								return registeredObjects[n];
							}
							if (!(d)) {
								d = document;
							}
                     try {
                        p = n.indexOf("?");
                     }
                     catch(e) {
                        p = 0;
                     }
							if (p > 0 && parent.frames.length) {
								d = parent.frames[n.substring(p+1)].document;
								n = n.substring(0,p);
							}
						  	if (!(x = d[n]) && d.all) {
								x = d.all[n];
							}
							for (i = 0; !x && i < d.forms.length; i++) {
								x = d.forms[i][n];
							}
						  	for (i=0; !x && d.layers && i < d.layers.length; i++) {
								if (d.layers[i].id.indexOf("external_") == -1) {
						  			x = BillzNavBarMM_findObj(n, d.layers[i].document);
								}
							}
							registeredObjects[n] = x;
						
						 	return x;
						}
						function BillzArrayContains() {
							var arg = BillzArrayContains.arguments;
							var foundit = false;
							var i = 0;
							for (i = 0; i < arg[0].length && !foundit; i++) {
								foundit = (arg[1] == arg[0][i]);
							}
							return foundit;
						}
						function NavBarRegisterLayer() {
							var arg = NavBarRegisterLayer.arguments;
							var n = arg[0];
							var d = arg[1];
							var mo = false;
							var o = null;
							if (arg[2] && arg[2] == 'MOutLayer') {
								mo = true;
							} else {
								mo = false;
							}
							if (!(BillzArrayContains(aryLayerNames, n))) {
								if (o = BillzNavBarMM_findObj(n)) {
									aryNavBarLayers[n] = o;
									BillzArrayPushUnique(aryLayerNames, n);
									aryNavBarLayerInfo[n] = new NavBarLayer(n, d, mo);
								}
							}
							return true;
						}
						function BillzNavBarMM_showHideLayers() {
						//v3.0 name changed, this function complements of MM Dreamweaver with customizations by Bill Heller
							var i = 0;
							var x = "";
							var obj = null;
							var v = null;
							var p = null;
							var args = BillzNavBarMM_showHideLayers.arguments;

							if (args[args.length - 1] != "menu") {
								nbMouseOutTimer();
							}
						  	for (i = 0; i < (args.length - 2); i += 3) {
								if (!aryNavBarLayers[args[i]]) {
									x = (args[i + 2] == 'show') ? 'hide' : 'show';
									NavBarRegisterLayer(args[i], x);
								}
						  		if ((obj = aryNavBarLayers[args[i]]) != null) {
									v = args[i + 2];
									aryNavBarLayerInfo[args[i]].isDefault = false;
						  			if (args[args.length - 1] == "restore") {
										v = (v == 'show') ? 'hide' : 'show';
									}
									if (obj.style) {
										obj.style.visibility = (v == 'show') ? 'visible' : ((v == 'hide') ? 'hidden' : v);
									} else {
										obj.visibility = v;
									}
								}
							}
							return true;
						}
                  
						function BillzNavBarRestoreLayers() {
							var i = 0;
							var x = "";
							var obj = null;
							var v = null;
							var p = null;
							var args = BillzNavBarRestoreLayers.arguments;
						  	for (i = 0; i < (args.length); i++) {
						  		if (obj = aryNavBarLayers[args[i]]) {
									v = aryNavBarLayerInfo[args[i]].defaultVisibility;
									if (obj.style) {
										obj = obj.style;
										v = (v == 'show' ) ? 'visible' : ((v == 'hide') ? 'hidden' : v);
									}
									obj.visibility = v;
									if (!aryNavBarLayerInfo[args[i]].MOutLayer) {
										aryNavBarLayerInfo[args[i]].isDefault = true;
									}
								}
							}
							return true;
						}
						function NavBarLayer() {
							var arg = NavBarLayer.arguments;
							this.defaultVisibility = arg[1];
							this.isDefault = true;
							this.MOutLayer = arg[2];
							return true;
						}
						function BillzNavMove() {
							return nbNavMove();
						}
                  function nbNavMove() 
                  {
							var thisl = null;
							var otherl = null;
							if (thisl = BillzNavBarMM_findObj("nbScrollLayer")) 
                     {
								if (thisl.style) {
									thisl = thisl.style;
									viz = "hidden";
								} 
								thisl.top = nbThisLoc -= 3;
								if (nbThisLoc < -750) {
									nbThisLoc = 325;
									nbTimes--;
								}
							}
							if (nbTimes <= 0) 
                     {
								otherl = BillzNavBarMM_findObj("BillzLayer");
								otherl.visibility = viz;
							} else {
								setTimeout("nbNavMove()", nbTime);
							}
							
							return true;
						}
						function NavBar_openadmin() {
							window.open('admin/', 'SiteAdmin', 'height=screen.availheight,width=screen.availwidth,scrollbars=1,toolbar=0,directories=0,status=0,menubar=0,resizable=1');
							return true;
						}
						window.onload = FullyLoaded;
					//-->
				</script>
				</HEAD>
 


	 
	 
	 
	 

	
	
	
	

	
	

	
	

	
	

	
	

	
	

	
	


	
	

	
	

	
	
	
	
	

	
	

	
	

	
	

	
	

	
		
		
	
		

	
		

	
		

	
		


 
	
	
	
		
	
	
	
	
		
		
	
<script language="JavaScript1.1" type="text/javascript">
<!--
// v1.1 Generated by PageSpinner, www.optima-system.com
gNumImages = 0;
var lastButton="";
function psHover(bName) 
{
	if (document.images) 
	{
		if (lastButton != "")
			psNormal(lastButton);
		lastButton=bName;
		if (!document.images[bName])
			return false;
		document.images[bName].src = hoverSrc[bName];
		if (clickSrc[bName])
		{
			tmpImage = new Image();
			tmpImage.src = clickSrc[bName];
			delete tmpImage;
		}
		if (imgStatusText[bName] != "")
		{ self.status = imgStatusText[bName]; return true; }
	}
	return false;
}
function psClick(bName) 
{
	if (document.images) 
	{
		lastButton=bName;
		if (!document.images[bName] || clickSrc[bName]=="")
			return true;
		document.images[bName].src = clickSrc[bName];
	}
	return true;
}
function psNormal(bName)
{
	if(document.images && bName != "")
	{
		if (document.images[bName])
			document.images[bName].src = normalSrc[bName];
		if (imgStatusText[bName] != "")
		{	self.status = ""; return true; }
	}
	return false;
}
function psRegImages(bName, normalSource, hoverSource, clickSource, width, height, statusText)
{
	if (document.images) 
	{
		gNumImages++;
		normalSrc[bName] = normalSource;
		hoverSrc[bName] = hoverSource;
		clickSrc[bName] = clickSource;
		imgStatusText[bName] = statusText;
		hoverImg[bName] = new Image();
		hoverImg[bName].src = hoverSource;
	}
}
if (document.images)
{
	hoverSrc	=	new Array(gNumImages);
	normalSrc	=	new Array(gNumImages);
	clickSrc	=	new Array(gNumImages);
	hoverImg	=	new Array(gNumImages);
	imgStatusText = new Array (gNumImages);
}
// -->
</script>
<script language="JavaScript1.1" type="text/javascript">
<!-- // psRollovers:

psRegImages("before", "http://www.pediatrix.com/ae_images/PregnancyV2/pregCenter/images/maindex1a.jpg", "http://www.pediatrix.com/ae_images/PregnancyV2/pregCenter/images/maindex1b.jpg", "", 263, 44, "Before You Get Pregnant");

psRegImages("stay", "http://www.pediatrix.com/ae_images/PregnancyV2/pregCenter/images/maindex2a.jpg", "http://www.pediatrix.com/ae_images/PregnancyV2/pregCenter/images/maindex2b.jpg", "", 263, 44, "Staying Healthy During Pregnancy");

psRegImages("9month", "http://www.pediatrix.com/ae_images/PregnancyV2/pregCenter/images/maindex3a.jpg", "http://www.pediatrix.com/ae_images/PregnancyV2/pregCenter/images/maindex3b.jpg", "", 263, 44, "9 Month Miracle");

psRegImages("special", "http://www.pediatrix.com/ae_images/PregnancyV2/pregCenter/images/maindex4a.jpg", "http://www.pediatrix.com/ae_images/PregnancyV2/pregCenter/images/maindex4b.jpg", "", 263, 44, "Special-Care Pregnancies");

psRegImages("plan", "http://www.pediatrix.com/ae_images/PregnancyV2/pregCenter/images/maindex5a.jpg", "http://www.pediatrix.com/ae_images/PregnancyV2/pregCenter/images/maindex5b.jpg", "", 263, 44, "Planning for Babys Arrival");

psRegImages("labor", "http://www.pediatrix.com/ae_images/PregnancyV2/pregCenter/images/maindex6a.jpg", "http://www.pediatrix.com/ae_images/PregnancyV2/pregCenter/images/maindex6b.jpg", "", 263, 44, "Labor and Delivery");

psRegImages("firstWeeks", "http://www.pediatrix.com/ae_images/PregnancyV2/pregCenter/images/maindex7a.jpg", "http://www.pediatrix.com/ae_images/PregnancyV2/pregCenter/images/maindex7b.jpg", "", 263, 41, "Your Babys First Few Weeks");
// -->
</script>

<body>
<table width="100%" height="100%"  border="0" cellpadding="0"  cellspacing="0">
	<tr> 
		<td height="100" align="left" valign="top">
			<table width="100%" height="100"  border="0" cellpadding="0"  cellspacing="0">
				<tr align="left" valign="top" bgcolor="DDDED8">
			  	
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<p>To download a form, right click on the link and select "Save Target As" and save the file to your computer.&nbsp;Or,&nbsp;click on the link and select&nbsp;"Print".&nbsp;You will need Adobe Acrobat Reader&reg; <a href="http://www.adobe.com/products/acrobat/readstep2.html" target="_blank"><img class="sm6generalwizard" src="images/Acrobat.jpg" border="0" align="textTop" /></a> &nbsp;to view these forms.</p>
<table border="0" width="100%">
<tbody>
<tr>
<td width="50%" align="left" valign="bottom"><strong><font color="#800000">New Patient Registration </font></strong></td>
<td width="50%" align="left" valign="bottom"><strong><font color="#800000">Notice of Privacy Practices</font></strong></td>
</tr>
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<td width="50%"><a href="https://www.pediatrix.net/public/webforms/mailform.asp?F=1" target="_blank"><strong>Online Registration</strong> </a>&nbsp;</td>
<td width="50%"><a href="http://www.pediatrix.com/workfiles/Compliance/NPP%20English.pdf" target="_blank">Notice of Privacy Practices - English</a>&nbsp;</td>
</tr>
<tr>
<td width="50%"><a href="workfiles/forms/ObxPatRegistration.pdf" target="_blank">Registration Form</a><a href="workfiles/forms/ObxPatRegistration.pdf" target="_blank"></a></td>
<td width="50%"><a href="http://www.pediatrix.com/workfiles/Compliance/NPP%20Spanish.pdf" target="_blank">Notice of Privacy Practices - En Espanol</a></td>
</tr>
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<td>&nbsp;</td>
<td><a href="http://www.pediatrix.com/workfiles/Compliance/NPP%20Acknowledgement%20English.pdf" target="_blank">Patient Acknowledgement - English</a></td>
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<td width="50%"><font color="#800000"><strong>Patient Questionaires</strong><em>(</em></font><font color="#000000"><sup><sub><em>Please complete if you are scheduled for a <br />New Prenatal visit or MD Consult)</em></sub></sup></font></td>
<td width="50%" align="left" valign="top">
<p><a href="http://www.pediatrix.com/workfiles/Compliance/NPP%20Acknowledgement%20Spanish.pdf" target="_blank">Patient Acknowledgement - En Espanol</a>&nbsp;</p>
</td>
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<td width="50%"><a href="https://www.pediatrix.net/public/webforms/mailform.asp?F=5" target="_blank"><strong>Online H&amp;P Questionnaire</strong></a></td>
<td width="50%"><a href="workfiles/forms/PATIENT_Ack_Form.Spanish.pdf" target="_blank"></a></td>
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<td width="50%"><a href="workfiles/forms/ob_history_questionnaire.pdf" target="_blank">OB Questionnaire</a>&nbsp;</td>
<td width="50%"><strong><font color="#800000">Medical Records Forms</font></strong></td>
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<td width="50%"><a href="workfiles/forms/family_history_questionnaire.pdf" target="_blank">Family History Questionnaire</a></td>
<td width="50%"><a href="workfiles/forms/Medical_record_request.rev.pdf" target="_blank">Medical Record Request</a>&nbsp;</td>
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<td width="50%"><a href="workfiles/forms/review_of_systems_questionnaire.pdf" target="_blank">Review of Systems Questionnaire</a>&nbsp;</td>
<td width="50%"><a href="workfiles/forms/Medical_records_release.rev.pdf" target="_blank">Medical Record Release&nbsp;</a></td>
</tr>
<tr>
<td>&nbsp;</td>
<td>&nbsp;</td>
</tr>
<tr>
<td width="50%" align="left" valign="top"><font color="#800000"><strong>Genetic Counseling&nbsp;Forms<br /></strong></font><font color="#000000"><sub><sup><em>(Please complete if you are scheduled for Genetic Counseling)</em></sup></sub></font></td>
<td width="50%" align="left" valign="bottom"><strong><font color="#800000">Referral Physician Form</font></strong></td>
</tr>
<tr>
<td width="50%">
<p><a href="workfiles/forms/genetic_questionnaire_english.pdf" target="_blank">Genetic Questionaire - English</a></p>
</td>
<td width="50%"><a href="workfiles/forms/OBXREQUESTFORM.2.2005.pdf" target="_blank">OB Referral Request Form</a>&nbsp;<a href="workfiles/forms/Medical_record_request.rev.pdf" target="_blank"></a></td>
</tr>
<tr>
<td width="50%"><a href="workfiles/forms/genetic_questionnaire_spanish.pdf">Genetic Questionaire - En Espanol</a><font color="#000000"> </font></td>
<td width="50%"><font color="#800000">&nbsp;&nbsp;&nbsp;&nbsp;</font><font color="#000000"> </font></td>
</tr>
<tr>
<td width="50%"><font color="#000000"></font></td>
<td width="50%"><font color="#000000"></font></td>
</tr>
<tr>
<td width="50%" align="left" valign="top"><strong><font color="#800000">Diabetes Program Forms</font></strong></td>
<td width="50%" align="left" valign="top"><strong><font color="#800000"></font></strong></td>
</tr>
<tr>
<td width="50%"><a href="workfiles/forms/DAPPreqform.2.2005.pdf" target="_blank">Sweet Success Program</a><font color="#000000">&nbsp; </font></td>
<td width="50%">&nbsp;</td>
</tr>
<tr>
<td width="50%">
<p><a href="workfiles/forms/Blood-Glucose-Eng.pdf" target="_blank">Blood Gluclose Tracking - English</a>&nbsp;</p>
</td>
<td width="50%">&nbsp;</td>
</tr>
<tr>
<td width="50%"><font color="#800000"><a href="workfiles/forms/DietRecord.pdf" target="_blank">Diet Record</a>&nbsp; </font><font color="#000000"></font></td>
<td width="50%"><strong><font color="#800000"></font></strong></td>
</tr>
<tr>
<td width="50%"><a href="workfiles/forms/PreliminaryDietInfo.pdf" target="_blank">Preliminary Diet Information</a>&nbsp;</td>
<td width="50%">&nbsp;</td>
</tr>
<tr>
<td width="50%">
<p><a href="workfiles/forms/Hypoglycemia.pdf" target="_blank">Hypoglycemia</a></p>
</td>
<td width="50%">&nbsp;</td>
</tr>
<tr>
<td width="50%">&nbsp;</td>
<td width="50%">&nbsp;</td>
</tr>
<tr>
<td width="50%">&nbsp;</td>
<td width="50%">&nbsp;</td>
</tr>
<tr>
<td width="50%">
<p>&nbsp;</p>
</td>
<td width="50%">&nbsp;</td>
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				strphrase = strphrase.replace(RegExpSearchPhrase,"");	
				if(strModifiedSearchPhrase.length){
					searchPhraseValue = '"' + searchPhraseValue + '"';					
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				strphrase = '"' + strphrase + '"';
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		}
		modifiedPhrase = strphrase + strSearchPhrases;
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				SM1_BannerItems[0][0].src='images/registration.gif';
				SM1_BannerItems[0][1]='https://www.pediatrix.net/public/webforms/mailform.asp?F=1';
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			function SM1_BannerClick(){SM1_BannerWindowStatus();
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		//-->
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