Best Birth Forward: childbirth education series
REGISTRATION FORM | May 12-June 30 series
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Email *
Please list your full name and preferred pronouns (i.e. she/her; he/him; they/them): *
What is the best phone number to reach you? *
What is your date of birth?
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What is your baby's EDD (estimated due date)? This series is best if your due month is July-October. *
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Where do you live? (city/province) *
What location do you plan to deliver your baby? (i.e. hospital name)
Who is your primary pregnancy care provider? *
What birth number is this for you?
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I highly recommend having a partner/support person present with you in class, if possible. Ideally, this is the same person who will support you during baby's birth. Please provide their name and relation, if applicable.
Is there anything you would like to share about your history/pregnancy that might help me better meet your family’s needs and expectations?
Are there any particular topics you would like to make sure are covered in class?
Are there any special needs/accommodations (academic or other) I should know about prior to the course to better support you?
There will be a private Facebook group for all class members to watch playbacks of recorded live sessions, be kept up to date, receive extra information, ask questions, discuss topics, keep in touch, etc. Do I have your consent to add you to this group via an e-mail invitation? You can reach out if this is an issue. *
How did you hear about this course and/or Belle Vie Birth & Baby? This helps me to understand how I'm best reaching clients.
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If you were referred by a friend, please provide their name so I can thank them!
How will you be paying for the course? The $300 fee (less the deposit if you pre-registered) is required to confirm your spot, unless otherwise discussed. If finances are a concern for you, select the option for me to reach out about flexible payment services. Thank you! *
How would you like to communicate following this form?
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Do you have any questions about the course before you confirm your spot?
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