APPLICATION PROCESS

First Name

Last Name

Age

Street Address

City

Province

Email

Phone

Partner's name

Which baby is this for you?

What was the first day of your last period?

What is this baby's due date?

Have you had midwifery care before?

Have you had any Caesarean section births?

If you have other children, please tell us briefly about their births.

If you have other children, please tell us briefly how the postpartum went for you and your baby/babies.

Where are you planning to give birth this time? If at home, please view our Home Birth Catchment Map

Why is this place of birth important to you?

Do you feel completely supported in your choice of birth place?

Tell us the single most important reason why you want midwifery care.

We strongly recommend that first time and VBAC moms hire a member of our doula team. Does this interest you?

JoySpring is a teaching practice. May student midwives participate in your care?

Is there anything else you think we should know about you, your health, or your birth plans?

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