ACCESS Plus Maternity Program

OBNA Form

The ACCESS Plus Program includes maternity services for low and high risk pregnant women. Please complete the Obstetrical Needs Assessment Form (OBNA) at the first prenatal visit and submit an updated OBNA form at the 28-32 weeks vist and the post partum visit. To ensure proper completion of the OBNA form please review the OBNA Tip Sheet.

The receipt of the OBNA form will initiate services to facilitate your care management for your patient. If the patient is low risk, a Nursing Care Coordinator from ACCESS Plus will contact your patient to offer assistance with needs such as transportation, appointment reminders, smoking cessation support, and other services. If your patient has a high risk pregnancy, an Obstetric (OB) Nurse from the DPW Intensive Care Management Team will provide ongoing telephonic support. This OB nurse will reinforce your care plan and will communicate directly with your office if any concerns arise.

The OBNA forms can be faxed to: 412-536-2022 or 412-367-5953.
The OBNA form is available in PDF and Microsoft Excel formats.

For questions regarding the form please contact:
ACCESS Plus
Attn: Maternity Program
9370 McKnight Road, Suite 300
Pittsburgh, PA 15237
Phone: 800-892-1028 option 4, option 1

Other Information/Forms

Med ED

ACOG Psychiatric Medication

Perinatal Mental Health Consultation Services Summary

(Downloadable file requires Adobe Acrobat Reader - Free Download)