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New Hampshire Family Care Plan

A Family Care Plan is a useful tool that helps you keep track of the services you are using, and to find new services and programs. A Family Care Plan is for people who are pregnant or who are the parents of a new baby. A Family Care Plan is also sometimes called a a Plan of Supportive Care or a Plan of Safe Care.

Talk to someone on your prenatal care team to start your Plan. Your care team can include healthcare professionals, a home visitor, recovery coach or any other professional helping you throughout your pregnancy.

Watch the two-minute video to learn what a Family Care Plan is and how to use it.

Family Care Planner

A Family Care Planner, will help you collect and organize information during your pregnancy and after the birth of your baby. The information in this planner is a way for you to share your Family Care Plan with your and your baby’s care team. Additional Parenting Resources are available to help you during your parenting journey.

Each tab represents each section of your planner. Click on the tab to see a full list of the documents that are included in a given section. You can also download, view, or print a full section or a specific document.

Welcome!
Read this letter which will introduce you to your Family Care Planner. This planner will help you collect and organize information during your pregnancy and after the birth of your baby. Download the Welcome Letter.

Tab 1: My Calendar
Use these calendars to keep track of your appointments, milestones, and events during and after your pregnancy. Download My Calendar.
My Yearly Calendars
My Monthly Calendar
My Weekly Calendar

Tab 2: My Notes
Use these blank note pages to jot down questions and thoughts during your appointments. Download My Notes.

Tab 3: My Family Care Plan
Read this overview document which provides information on what a Family Care Plan is. Use this template to create your Plan. Download the Family Care Plan Overview and Family Care Plan Template.
Tab 4: My Health Information

MY CONTACT LIST – Use this section to keep track of the people who are part of your care team. This section also includes adhesive sleeves to place business cards.
MY APPOINTMENTS – Use this log to track your appointments.
MY MEDICATION LIST – Use this document to list information about your medications.
MY ALLERGY LIST – Use this document to list information about your allergies.
MY PREGNANCY INFORMATION – Read this information which talks about who can be part of your care team during pregnancy and how they can help.
WARNING SIGNS – Review this handout which includes a list of maternal warning signs during and after pregnancy.
MY PREGNANCY JOURNAL – Use this journal to write down your feelings, questions and goals.
MY HOSPITAL BAG CHECKLIST – List of items you may want to pack in your hospital bag.
MY POSTPARTUM INFORMATION – Read this information which talks about some of the changes you can expect during the postpartum period.
MY COMMUNITY RESOURCES – List of community services and support.

Download My Health Information.

Tab 5: My Baby’s Information

MY BABY’S CONTACT LIST – Use this section to keep track of the people who are part of your baby’s care team. This section also includes adhesive sleeves to place business cards.
MY BABY’S APPOINTMENTS – Use this log to track your baby’s appointments.
MY BABY’S MEDICATION LIST – Use this document to list information about your baby’s medications.
MY BABY’S ALLERGY LIST – Use this document to list information about your baby’s allergies.
MY SUPPLIES CHECKLIST – A list of common baby items and supplies.
CHOOSING A PROVIDER FOR MY BABY – Read this information which talks about how to choose a primary care provider (PCP) for your baby.
QUESTIONS TO ASK YOUR BABY’S PROVIDER – List of essential questions to discuss with your baby’s PCP.
CARING FOR YOUR BABY: Making the Most of Your Time in the Hospital – Read this information to learn how to care for a baby who is at risk for Neonatal Abstinence Syndrome (or NAS) due to exposure to an opioid during the pregnancy.
MY NEWBORN CARE DIARY – Use this diary to write down your baby’s activities.

Download My Baby’s Information.

Tab 6: My Consents
Read this overview document which provides information on what consents and releases of information forms are. Use this log to keep track of signed forms. Download the My Consents & Releases of Information Overview and My Consents & Releases of Information Log.

Tab 7: Other Resources

BUDGET TOOLS – Use this form to keep track of income, expenses and savings.
GROCERY PLAN – Use this grocery plan to prepare weekly meals.
GROCERY LIST – Use this list to write down weekly or monthly groceries.

Download the Other Resources.

The materials on this webpage were developed in collaboration with the NH Perinatal Substance Exposure Collaborative and an Advisory Group of pregnant and parenting individuals with funding from the New Hampshire Charitable Foundation and the Maternal and Child Health Section of the NH Department of Health and Human Services, Division of Public Health Services.