Skip to Main Content

Notification of Pregnancy

Short Version

Completion of this form will allow us to support you to the best of our ability to ensure you have a healthy and successful pregnancy. This form is also used to tell Meridian your interest in the Safe Sleep Crib Program

Once this form is completed, a Meridian representative will call you to complete a full pregnancy and health risk assessment, share information about community resources and your pregnancy benefits, and confirm delivery details for the Pack N’ Play crib. This call must be completed to receive the crib. This form is private. 

Would you like to receive texts about pregnancy/newborn care? required *
Have you had an inpatient stay this pregnancy?
2. Do you have any chronic conditions such as high blood pressure, diabetes, asthma, or sickle cell disease during or before pregnancy?
3. Do you have a history of or currently taking progesterone, have preterm labor, or a short cervix?
What is your housing situation today?
In the past two months, did you or others you live with eat smaller meals or skip meals because you did not have enough money for food?
In the past 12 months, has a lack of reliable transportation kept you from going to medical appointments, meetings, work, or doing things needed for daily living?
In the past 12 months, has the electric, gas, oil, or water company threatened to shut off services in your home?
Do you feel unsafe in your daily life?
Are you unemployed or without regular income?
How often do you feel lonely?
Which of the following would you like to get help with at this time? Select ALL that apply.

 

DISCLAIMER:

Please be aware that email communication, including attachments, may not be secure and could be intercepted, corrupted, lost, destroyed, delayed, incomplete, or contain viruses. Therefore, the integrity of email transmission cannot be guaranteed.

By communicating with us via email, you acknowledge and accept these risks. While we take reasonable precautions to ensure the security and confidentiality of email transmissions, we cannot guarantee the security of any information transmitted via email.

It is important to refrain from including sensitive or confidential information in email messages unless encrypted or otherwise protected. If you have concerns about the security of your communication or need to transmit sensitive information, please consider using alternative secure methods of communication.

We disclaim any liability for damages arising from the use of email communication, including but not limited to any direct, indirect, incidental, consequential, or punitive damages, whether foreseeable or not, resulting from the transmission or reception of email messages.

If you have any questions or concerns about the security of email communication, please call Member Services at 1-888-437-0606 (TTY 711).

 

Public Benefit Assistance Programs

Did you know that you can apply for many public benefits from the comfort of your home using the internet on your computer, tablet, or phone? MI Bridges lets you apply for public benefit programs. You can apply for benefits, manage your case, and explore local and state resources. Other programs you may be able to use include:


You can find details on the Family Independence Program (FIP), State Disability Assistance (SDA), Social Security Income (SSI), help for refugees, and other cash assistance.

MI Bridges



You can find details on the Family Independence Program (FIP), State Disability Assistance (SDA), Social Security Income (SSI), help for refugees, and other cash assistance.

MI Bridges



You can find details on the Food Assistance Program (FAP) and whether you’re eligible, as well as other food resources.

MI Bridges




Find more details at michigan.gov/helpinghand.


You can find details on how you can get help with home repairs, heat and utility bills, relocation (moving), home ownership, burials, home energy, and what’s needed to be eligible.

You can visit michigan.gov/mibridges to get started! The application is available in English, Spanish, and Arabic.

MI Bridges

This program gives grant funds to states and territories to provide families with financial help and related support services. State programs may include child care assistance, job prep help, and work assistance. To be eligible for TANF, you must be a resident of Michigan and a U.S. citizen, legal alien, or qualified alien. You must be unemployed or underemployed and have low or very low income. You must also be one of the following:

  • Have a child 18 years of age or younger.
  • Be pregnant.
  • Be 18 years of age or younger and the head of your household.
MI Bridges



Find out more by visiting mi211.org or calling 211.

MI Bridges

WIC is a program that helps pregnant and postpartum people, infants, and children through an important time of growth and development. WIC provides nutritious foods, nutrition education, breastfeeding/chestfeeding support and referrals to other community programs to improve and support clients’ health and well-being. Get support and learn how to have healthy pregnancies and get breastfeeding/chestfeeding off to a good start. Their nutrition staff and registered dietitians will work with you to meet your family’s needs. WIC offers support and guidance to help you feed and care for your family in a healthy way.

MI Bridges


Lifeline is both a state and federal program that provides discounts on telecommunications (telephone) and broadband (internet) service to certain low-income customers. Eligible low-income members can get monthly discounts on their telephone and broadband services. Lifeline discounts may vary depending on state and federal eligibility, as well as type of service and provider.

MI Bridges

More resources may be available within your local community, and Meridian is happy to support you in finding the help you need. Visit findhelp.mimeridian.com to find resources, such as food, housing, healthcare, support, transportation, education, legal support, and more. You can also call Member Services at 1-888-437-0606 (TTY: 711).  

Last Updated: 06/04/2025