Preparing for Birth Childbirth Education Course Registration

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By completing this form, you are acknowledging that the childbirth educator is not providing medical advice in this course and encourages all people to consult with their healthcare provider for medical guidance

Email *

Name *

Partner's Name *

Due date *

Course *

Small Group Course

Private Course

I'd like to set up an exploratory call to learn about both offerings

Course Date (Group Offering)

April 14th 2024 (Sunday) from 1-4:30pm

July 2024 date TBD

October 2024 date TDB

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Mode of payment ($175 for one day group session or $350 for four hours of private education and ongoing support via phone and text leading up to your birth. Both course options include a Preparing For Birth Course Journal valued at $30) *

Cash

Check made payable to Lauren Seipel

Venmo: @ljseipel20

Intended place of birth *

Healthcare provider's name *

Phone number *

Any additional thoughts, questions, or notes you'd like to share for me to get to know you better?!

A copy of your responses will be emailed to the address you provided.

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