New Patient Appointment Request - Midwifery Care, Birth Center Delivery
WELCOME! If you would like to make an appointment please complete this form. Your information is confidential. We encourage you to correspond via email and text as our phone lines are extremely busy.

HAVE QUESTIONS FIRST ????

If you are interested in more information about our natural birth and water birthing services at The Birth Place we are happy to help you.

Please email Juana Duran on receptionist@thebirthplace.org for a speedier response to payment and insurance questions.

Please email juana.browne@commonsensechildbirth.org for general questions about our service and to set up a tour, or click here to request a tour appointment https://forms.gle/qqhjtinSGEBLvZ8Y7.

Please email Midwife Becky Keffer Machado on becky@commonsensechildbirth.org for medical concerns, and/or midwifery and birth center questions.

If you have already left a voicemail message on our main line your message will have been transcribed and has been directed to the receptionist's inbox and she will respond within 24-48 hours. If you have an EMERGENCY please go to your nearest hospital or call 911.

Please check our website- www.thebirthplace.org and our Facebook page - https://www.facebook.com/thebirthplace

For more about our owner/founder and Clinical Director JENNIE JOSEPH - https://jenniejoseph.com

THANK YOU AND CONGRATULATIONS!
Email address *
The Birth Place - Birth Center, Winter Garden -Juana Duran, Front Desk
The Birth Place - Birth Center, Winter Garden -Juana Browne, Patient Support Coordinator
The Birth Place - Birth Center, Winter Garden -Becky Keffer Machado, LM, CPM Midwife
Next
Never submit passwords through Google Forms.
This form was created inside of Commonsense Childbirth - THE BIRTH PLACE Inc. Report Abuse - Terms of Service