Client Intake

Congratulations on your pregnancy!

When we receive your form, our office staff will check to see if we have room in our clinic during the time that you are due. Someone will contact you within the week to let you know, and if so, book an initial appointment with one of our midwives. If you have not received a call by then, please feel free to send another form and/or give us a call at (807) 344-2229.

Background Information


Pregnancy History

 Home Hospital
 Repeat Client Friend Family Doctor Other (Please Specify)