Register for your workshop today!

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Please take a moment to answer these questions as will help us customize the workshop to meet your interests.

You can expect to receive an email from us within 24 - 48 hours of sending your response! In the meantime, please email us at info@4thTrimesterPlan.com with questions!

The virtual "Beyond the Birth" workshop

Name *

Phone Number

Due Date

YYYY

Which online workshop would you like to attend? (It's a 4-part series.)

I'd prefer Individualized Coaching (We'll customize the number of sessions, days and times.)

Tuesdays, 6p - 8p | MAR 5, 12, 19 & 26

Sundays, 1 - 3p | MAR 3, 10, 17 & 24

Tuesdays, 6p - 8p | APR 2, 9, 16 & 23

Sundays, 8:30a - 10:30a | APR 7, 14, 21 & 28

Tuesdays, 6p - 8p | MAY 7, 14, 21 & 28

Are you expecting twins?

Yes

Clear selection

How many pregnancies have you had?

None

3 or more

Clear selection

How many living children do you have?

None

3 or more

Clear selection

Living childrens' names & ages:

Was this a planned pregnancy

Yes

Preferred birth method:

C-section

Vaginal

Other:

Clear selection

Preferred birth location:

Hospital

Birth Center

Home

Other:

Clear selection

Preferred baby feeding method:

Breast

Formula

Exclusively pumping

Undecided

Other:

Employment status:

Full-time employment outside the home

Part-time employment outside the home

Working inside the home only

Other:

If employed, expected time-off after baby:

Projected employment status after baby:

Full-time employment outside the home

Part-time employment outside the home

Working inside the home only

Undecided

Other:

Partner's expected time off after baby

Maternal / Paternal cultural heritage (e.g. as many known countries, regions, or ethnicities):

What do you hope to gain from the workshop?

How to build a broader support network

Nourishing foods for my 4th Trimester

Therapies / treatments to aid my 4th Trimester recovery

How to balance life with my older kids & baby

Other:

Which best describes your approach to planning?

I love planning everything!

I plan some things.

I don't really consider myself a planner.

Other:

Clear selection

Check any of the following that describe your situation:

Financial stress

Marital stress

Pregnancy complications

Personal or family history of depression, anxiety or postpartum depression

Premenstrual dysphoric disorder (PMDD)

A major recent life event: loss, house move, job loss, etc

Having multiples

Received infertility treatment

Thyroid imbalance

Diabetes (type 1, 2 or gestational)

None of the above

Will your partner attend the session?

Yes

Maybe

Clear selection

How did you hear about the "Beyond the Birth" workshop?

Is there anything else we should know?

Your workshop tuition is determined by gross family income. Please let us know how you intend to pay.

Pay with Zelle | email address: elizabeth@4thTrimesterPlan.com

Pay via PayPal

Other:

Submit

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