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Childbirth Education Class
Dates: December 1st and December 8th, 2022
Times: 6:00-9:00pm
Address: 3875 Wrightsboro Road Augusta, GA 30909
Contacts:
Julia Davidson: 518-588-3716 (
littlehandslittlefeetdoula@gmail.com
)
Cost: $200 (Admits 1 pregnant person and their partner)
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Email
*
Your email
Name
*
Your answer
Phone
*
Your answer
Due Date
MM
/
DD
/
YYYY
Planned Birth Location
Home
Hospital
Birthcenter
Provider Name:
*
Your answer
Number of previous pregnancies?
Your answer
What type of birth are you planning?
Unmedicated Vaginal Birth
Medicated Vaginal Birth
Planned Cesarean
Vaginal Birth After Cesarean (VBAC)
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Are you currently seeing any of the following?
Chiropractor
Acupuncturist
Pelvic Floor Specialist
Prenatal Yoga Instructor
Other:
What are you hoping to learn from this class?
Your answer
Will you be attending class with anyone?
*
Partner/Spouse
Doula
I will be attending alone.
Other:
Required
Do you currently have a doula?
Yes
No
No, but I would like more information on doula support!
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How did you hear about this class?
Facebook
Instagram
Word of Mouth
Other:
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Anything else we should know about you?
Your answer
I understand that a payment of $200 must be made in full prior to November 25th, 2022 in order to secure my seat.
*
Childbirth Education Class Full Price - $200
Cost is a barrier to my attendance.
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