Birth & Beyond Childbirth Education Course
Congratulations on your decision to take a Childbirth Education Course!  

The Birth and Beyond curriculum stands out from most other courses in that the education you receive encompass not only pregnancy and labor information, but detailed information on the commitment of a partner during labor, the effect the birthing environment has on labor, postpartum and newborn information.

Please use the following form to register and reserve your spot in the Spring weekend series. Once the registration form has been received, an email with detailed course information and course invoice will be sent.  

Do not hesitate to contact me with any questions!

 
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Email *
Birthing Person’s First and Last Name *
Birthing Person’s Cell Phone Number *
Home Address *
When is your estimated guess date? (Due Date) *
MM
/
DD
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Partner or Support Person's First and Last Name *
(The person who will be attending class with you.  This person should also be present at the birth, as the course emphasizes the importance of the support persons commitment)
Partner or Support Person's Cell Phone Number
Partner or Support Person's Email Address
Is it ok to Contact Your Partner or Support Person ? *
Who is Your Care Provider for This Pregnancy? *
Where is Your Planned Place of Birth?   *
(Please specify which hospital, birthing center, or other location if birth will not be at you home)
How Did You Hear About This Course? *
What Number Pregnancy is This? *
What Number Birth is This? *
If You Have Had Previous Births, Please List if They Were Vaginal, Cesarean, or Vaginal Birth After Cesarean (VBAC), and Any Additional Information About These Births You Would Like to Provide.
Do You Plan to Have Any Other Labor Support Present at Birth? *
If You Plan on Having Additional Persons at Your Birth, Please List Who And What Their Role Is.
How Do You Feel About Taking This Course? *
How Does Your Partner/Support Person Feel About Taking This Course? *
What Do You Hope To Learn From This Course? *
What Is The Main Goal For Your Birth? *
List Any Special Concerns or Information You Would Like Me To Know Prior To You Attending Class:
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