I want more information about Charlene and her offerings...
Please take 5 minutes to fill out this form so that I can find the best way to assist you and for us to meet up in person (which is preferred) or virtually via Zoom or Skype. Subsequent visits are in person. I am looking forward to connecting with you. *Free doula consultations are offered if you have completed the Relax into Birth programme. If you do not use my doula services there will be a R350 fee for the consult, otherwise there is no charge. 
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Correo electrónico *
When is your estimated due date? *
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Mother's Name & Surname *
Mother's Mobile Number for WhatsApp communication *
Father/Partner's Name & Surname *
Father / Primary Partner's Number for Whatsapp communication *
What country & city are you living in? (i.e. where will you be birthing your baby?) *
Who are your primary caregivers? (Gynae/Obstetrician name and/or Independent midwives?) *
Where do you hope to give birth? Home/Hospital? Which hospital? *
Are you planning on hiring a doula? If you have already hired a doula, who have you hired? (For birth back-up purposes, this is helpful.) *
Please tick the boxes below to indicate *
Obligatoria
How did you hear about Relax Into Birth / Charlene Yared West? *
What other antenatal classes have you done? And with whom? *
Is this your first pregnancy?
How many children do you have? *
Please input your enquiry here. *
*Free doula consultations are offered if you have completed the Relax into Birth programme
*If you do not use my doula services there will be a R350 fee for the consult, otherwise there is no charge. 
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