Register for your workshop today!
Please take a moment to answer these questions as will help us customize the workshop to meet your interests.
You can expect to receive an email from us within 24 - 48 hours of sending your response! In the meantime, please email us at info@4thTrimesterPlan.com with questions!
* Required
Name
*
Your answer
Phone Number
Your answer
Email
Your answer
Facebook handle
Your answer
Due Date
MM
/
DD
/
YYYY
Which online workshop would you like to attend?
Thursdays, 6 - 8 pm; March 4, 11, 18 & 25
Saturdays, 8 - 10 am; April 3, 10, 17 & 24
Wednesdays, 6 - 8 pm; April 7, 14, 21 & 28
Saturdays, 9 - 11 am; May 1, 8, 15 & 22
Thursdays, 6 - 8 pm; May 6, 13, 20 & 27
Saturdays, 9 - 11 am; June 5, 12, 19 & 26
Wednesdays, 6 - 8 pm; June 9, 16, 23 & 30
I'd like one-on-one support. (This is the only option available at this time.)
Twins?
Yes
NO
Clear selection
How many children do you currently have?
None
1
2
3 or more
Clear selection
Other children names & ages:
Your answer
Preferred birth method:
C-section
Vaginal
Other:
Clear selection
Preferred birth location:
Hospital
Birth Center
Home
Other:
Clear selection
Preferred baby feeding method:
Breast
Formula
Exclusively pumping
Undecided
Other:
Employment status:
Full-time employee
Part-time employee
Mom
Other:
If employed, expected time-off after baby:
Your answer
Projected employment status after baby:
Full-time employee
Part-time employee
Mom
Undecided
Other:
Partner's expected time off after baby
Your answer
Maternal / Paternal cultural heritage (e.g. as many known countries, regions, or ethnicities):
Your answer
What do you hope to gain from the workshop?
How to build a broader support network
Nourishing foods for my 4th Trimester
Therapies / treatments to aid my 4th Trimester recovery
How to balance life with my older kids & baby
Other:
Which best describes your approach to planning?
I love planning everything!
I plan some things.
I don't really consider myself a planner.
Other:
Clear selection
Check any of the following that describe your situation:
Financial stress
Marital stress
Pregnancy complications
Personal or family history of depression, anxiety or postpartum depression
Premenstrual dysphoric disorder (PMDD)
A major recent life event: loss, house move, job loss, etc
Having multiples
Received infertility treatment
Thyroid imbalance
Diabetes (type 1, 2 or gestational)
None of the above
Will your partner attend the session?
Yes
No
Maybe
Clear selection
How did you hear about the "Beyond the Birth" workshop?
Your answer
Is there anything else we should know?
Your answer
Your workshop tuition is determined by gross family income. Please let us know how you intend to pay.
I'll pay online now @
www.4thTrimesterPlan.com/cart
Please send me a PayPal invoice.
Other:
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